A nurse is reviewing contraception options for four clients. The nurse should identify that which of the following clients has a contraindication for receiving oral contraceptives.
A.
A 26-year-old client who has migraine headaches at the start of each menstrual cycle
B.
A 28-year-old client who has a history of pelvic inflammatory disease
C.
A 32-year-old client who has benign breast disease
D.
A 38-year-old client who reports smoking one pack of cigarettes every day
The correct answer is:
D. A 38-year-old client who reports smoking one pack of cigarettes every day
Explanation:
Oral contraceptives (OCs) are generally contraindicated in individuals who smoke, especially those over the age of 35, due to the increased risk of thromboembolic events (e.g., blood clots). Smoking increases this risk significantly, making it a strong contraindication for the use of oral contraceptives.
Here’s why the other options are less of a concern:
- A. A 26-year-old client who has migraine headaches at the start of each menstrual cycle: Migraine headaches are not an absolute contraindication for oral contraceptives unless they are accompanied by aura or are particularly severe. Many women with migraines use OCs safely.
- B. A 28-year-old client who has a history of pelvic inflammatory disease: A history of pelvic inflammatory disease (PID) is not an absolute contraindication for oral contraceptives. It may, however, influence the choice of contraceptive method, but it does not generally preclude the use of OCs.
- C. A 32-year-old client who has benign breast disease: Benign breast disease is not a contraindication for oral contraceptives. In fact, oral contraceptives are sometimes used to manage certain types of benign breast conditions.
Therefore, the client who is a 38-year-old smoker is at a higher risk for complications related to oral contraceptive use and should be counseled on alternative contraceptive methods.