Safety and Absolute Contraindications – Oral Contraceptives (OCs) (Nursing)

00:01 Now I want to use the World Health Organization contraindications.

00:05 These are category for oral contraceptives.

00:09 If the patient has a history of a thromboembolic disorder, that means someone who's had a clot like a DVT deep vein thrombosis or a PE a pulmonary embolus.

00:21 They should not absolute contraindication.

00:24 So it's category for means they should not take oral contraceptives if they're older than 35 and smoke 15 or more cigarettes a day.

00:33 This is not a safe option for them.

00:36 If they've had a major surgery with prolonged immobilization meaning they didn't move around a lot.

00:42 They're at an increased risk for clots.

00:44 And so we don't want them to take these medications.

00:47 Now if they have a curtain history of ischemic heart disease or stroke, again, oral contraceptives are out.

00:54 They have complicated valvular heart disease and if they have migraine headaches with an aura, now that's really specific.

01:02 But they found that migraine headaches if the patient has an aura that kind of feeling before, this is an absolute contraindication if they currently have breast cancer or history of breast cancer, or if they have any of these other liver problems.

01:16 Okay, here we go again.

01:18 You're sitting down a study and got this big giant list.

01:23 So what can you do as you're working through this to know that this would absolutely be a contraindication for oral contraceptive.

01:30 If we want to keep our patients safe, so it's important as a nurse at your educated to know that.

01:35 We also want to get good grades on tests questions.

01:38 So this is something that we could see in a test question.

01:42 So, how do we group these together while the first one would be clots, right? And then next to it I have heart so I could put a heart in between the two of those to help me remember, it's kind of in my circulation.

01:57 We've got smoking.

01:59 We got headaches with an aura.

02:00 I want you to figure out what's the best system for you to address how am I going to remember this list of things? You can't memorize these eight list, you want to look for ways that make sense to you to chunk the information together.

02:16 Now Category 3 means we want to be really careful if we would do this so if their postpartum, less than 21 days and not breastfeeding if they're breastfeeding greater than six weeks or less a six months postpartum if they're 35 years or older but they smoke less than 15 cigarettes a day if they've had a medically treated or current gallbladder disease that might be a problem.

02:40 We're going to look at their blood pressure, Is there blood pressure being adequately controlled, do we know that they already have Hyperlipidemia, or elevated lipids.

02:49 Now there's even more criteria.

02:51 What I want you to have in mind is It's not just a simple decision to go on oral contraceptives.

02:58 There's lots and lots of risk factors and we've gone with the World Health organization's contraindications for you.

03:04 What your job is going to have to be is to walk through all these contraindications and make sure you spend some time reviewing those because you will likely work with patients who are on oral contraceptives and may not be aware of these contraindications.

03:18 Now, they've had long term diabetes for more than 20 years.

03:21 They've gotten a nephropathy, retinopathy or some other vascular diseases.

03:25 This is something that you really want to be careful with.

03:28 If they take special medications for seizures.

03:31 This is another reason why you use this with great caution.

03:34 Now if a patient has migraine headaches without aura and their age 35 or older, we're a little more concerned but not as concerned as we were with the migraines with aura.

03:45 Now look at your downloadable material, you've got more contraindications there and we'll let you look at those and make some notes for yourself on how you can chunk that information together.

03:56 The takeaway point is it's not a simple thing to start oral contraceptives.

04:00 You need a very detailed health history with your patient you need open communication and you need to ask them lots of these questions that will screen them for any of these risk factors.