Directions
Read and analyze this case study individually. When
others in your group have finished reading it, answer the questions.
When all the groups have finished, we will discuss the case study and
the answers each group developed.
Case Study
The client is a 28-year-old mother of three children.
The youngest is 4 years old and his birth was very difficult. She does
not want to have any more children and her husband agrees. To prevent
further pregnancies, she began taking Depo-Provera injections about 1
year ago. It is not yet time for her next injection but she has returned
to the clinic because she is worried—she has not had a menstrual
period for two months and is afraid that the menstrual blood is building
up inside of her.
Questions
-
What are the possible causes of the client’s
amenorrhea?
-
What additional information do you need to
determine the most likely cause? What questions will you ask? What
examinations will you perform?
-
You find no cause for the amenorrhea other than
the Depo-Provera. How would you manage this client?
-
What will you tell the client about the cause of
her amenorrhea and its management?
-
Despite your explanations, the client insists on
stopping the Depo-Provera. What other family planning methods might
be appropriate for her? Why?
Directions
Read and analyze this case study individually. When
others in your group have finished reading it, answer the questions.
When all the groups have finished, we will discuss the case study and
the answers each group developed.
Case Study
The client is a 25-year-old woman. She is married and
has four children. Her youngest child is 1 year old. She wants no more
children for several years. Her husband, a truck driver, will not use
condoms, so she began taking Depo-Provera injections 7 months ago. Just
last month she received her third injection. At that time, she reported
having some light spotting between periods.
Now she has returned to the health post saying that
she has been having heavy bleeding for the past 10 days. She is very
frightened and concerned.
Questions
-
What should you have told her about the light
spotting?
-
What are the possible causes of her heavy
bleeding?
-
What additional information do you need to
determine the most likely cause? What questions will you ask? What
examinations will you perform?
-
No other abnormalities are found. Is there any
medical treatment you would give her?
-
What would you tell her about the bleeding? Is
there any other information or counseling she needs?
-
If there is no response to the treatment or the
client decides that she wishes to change to another family planning
method, which methods may be appropriate for her? Which would not
be appropriate for her?
