| Course | NU 631 Healthcare of Women across the Lifespan |
|---|---|
| Unit | Unit 2 |
| Paper type | Contraception counseling record |
| Length | About 900 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN Family Nurse Practitioner |
| Updated | October 2026 |
Free sample paper for NU 631 Unit 2
Contraception Counseling Record: A 29-Year-Old With Migraine With Aura Who Wants Fewer Periods
Student Name
Department of Nursing, Herzing University
NU 631: Healthcare of Women across the Lifespan
Instructor Name
February 2, 2026
Contraception Counseling Record: A 29-Year-Old With Migraine With Aura Who Wants Fewer Periods
What She Wants From a Method
Ms. R., a composite 29-year-old paralegal, came to discuss contraception after stopping a combined oral contraceptive three months ago, when a neurologist diagnosed migraine with aura. She has been using condoms since. In her words, she wants a method that "I don't have to think about every day," that "makes my periods lighter or stops them," and that she can stop easily because she may want a child in two or three years. Effectiveness matters to her, but less than not having to remember a daily pill. She does not want an injection because she is afraid of needles. These priorities were recorded first because they decide which options are worth discussing at length; counseling that starts from the patient's goals rather than from a clinician's preferred method supports both satisfaction and continued use (Dehlendorf et al., 2014).
History Bearing on Eligibility
Migraine with aura, visual zigzag lines lasting about 20 minutes before headache, confirmed by neurology. No history of venous thromboembolism, stroke, hypertension, diabetes, liver disease, or breast cancer. Blood pressure 118/74. Body mass index 26. Nonsmoker. Not breastfeeding. Medications: sumatriptan as needed. Previous methods: combined oral contraceptive for eight years, which she liked for lighter periods; she once used a copper intrauterine device for six months at 22 and had it removed because of heavier, more painful periods. Periods now are regular, heavy for two days, with moderate cramping.
Eligibility, Applying a Named Criteria Set
The current federal criteria set, the 2024 update of the U.S. MEC, was applied (Nguyen et al., 2024). For migraine with aura, combined hormonal methods, including the pill, patch, and ring, are category 4, an unacceptable health risk, because of the increased risk of ischemic stroke with estrogen in women who have aura. Progestin-only methods and the copper intrauterine device are category 1 for migraine with aura, meaning no restriction. No other condition in her history changes these categories. The combined methods she liked before are therefore not options, and she was told why in plain terms: "The estrogen in your old pill can raise the risk of stroke in people who get migraine with aura."
Options That Fit Her Priorities
Effectiveness was presented as the percentage of people who become pregnant in the first year of typical use, because typical use reflects missed pills and late injections and is what she can expect (Trussell, 2011).
Levonorgestrel intrauterine device (52 mg): fewer than 1 in 100 pregnancies per year in typical use; lasts up to eight years for pregnancy prevention; periods usually become much lighter and some people stop bleeding, although irregular spotting is common in the first three to six months; placed in the office, and removed whenever she chooses, with fertility returning quickly. Usually covered by her insurance without cost sharing.
Etonogestrel implant: fewer than 1 in 100 pregnancies per year; lasts at least three years; placed in the upper arm with a small numbing injection; bleeding pattern is unpredictable, with about one in five having frequent or prolonged bleeding. Fertility returns quickly after removal.
Copper intrauterine device: fewer than 1 in 100 pregnancies per year; no hormones; but she had heavier, more painful periods with it before, which conflicts with her priority.
Progestin-only pill: about 9 in 100 pregnancies per year in typical use; she would need to take it daily, which conflicts with her priority.
Injectable medroxyprogesterone: about 6 in 100 pregnancies per year in typical use; she declined it because of needles; also, return of fertility can be delayed several months after stopping.
What She Asked and What Concerned Her
She asked whether the levonorgestrel device would make her migraines worse. She was told it releases a small amount of progestin and does not contain estrogen, and that it has no restriction for migraine with aura in the eligibility criteria. She asked about pain with placement; the options for pain relief were explained, including an injection of local anesthetic, and she was told most people describe cramping for a few minutes. She was concerned about spotting in the first months; she was told honestly that this is common and usually improves, and that it is one of the most frequent reasons people remove the device early, so it helps to know in advance.
Decision and Plan
She chose the levonorgestrel 52 mg intrauterine device, because it best matched her three priorities: no daily action, lighter periods, and easy reversibility for a pregnancy in two to three years. She declined the implant because of the unpredictable bleeding, the copper device because of her past experience, the progestin-only pill because it requires daily use, and the injection because of needles and delayed return of fertility. Her reasons are recorded because they will allow a later clinician to revisit the decision in her own terms.
Placement is scheduled for next week. A urine pregnancy test will be done at the visit, and she will continue using condoms until then. Backup contraception for seven days after placement is needed unless it is placed within seven days of the start of her period. Chlamydia and gonorrhea screening was offered and she accepted. She was told to return for fever, severe pelvic pain, or heavy bleeding after placement, and she has a follow-up call scheduled at three months to review bleeding and satisfaction.
References
Dehlendorf, C., Krajewski, C., & Borrero, S. (2014). Contraceptive counseling: Best practices to ensure quality communication and enable effective contraceptive use. Clinical Obstetrics and Gynecology, 57(4), 659-673. https://doi.org/10.1097/GRF.0000000000000059
Nguyen, A. T., Curtis, K. M., Tepper, N. K., Kortsmit, K., Brittain, A. W., Snyder, E. M., Cohen, M. A., Zapata, L. B., & Whiteman, M. K. (2024). U.S. medical eligibility criteria for contraceptive use, 2024. MMWR. Recommendations and Reports, 73(4), 1-126. https://doi.org/10.15585/mmwr.rr7304a1
Trussell, J. (2011). Contraceptive failure in the United States. Contraception, 83(5), 397-404. https://doi.org/10.1016/j.contraception.2011.01.021
Reading the NU 631 Unit 2 instructions
The Unit 2 assignment asks you to document contraception counseling for a patient, usually one with a condition that affects eligibility. Expect to record the patient's priorities first, such as effectiveness, bleeding pattern, daily action or reversibility. A history focused on eligibility should follow, and a named criteria set, such as the US MEC, should be applied with categories stated. Options that fit should be presented with effectiveness in typical use and honest discussion of side effects. Many sections require the patient's questions and concerns to be documented. The decision and plan, including timing, backup contraception and follow-up, close the record. Cite the criteria set and effectiveness sources in APA 7. Write it as a clinical record rather than an essay, and use an invented patient.
How this NU 631 Unit 2 example is built
The record opens with what she wants: no daily pill, lighter or no periods and the option to conceive in a few years. The history section lists the aura details confirmed by neurology and the absence of clotting history, smoking and hypertension. Eligibility is then applied category by category, showing why combined pills, the patch and the ring are excluded and which methods remain. Options are presented with first-year typical-use pregnancy rates, explaining why typical use is more realistic than perfect use. Her questions are recorded with direct answers, including expected bleeding changes with the hormonal device. The decision section explains why the levonorgestrel device matched all three priorities. The plan covers insertion timing, pain management for insertion, backup if needed and a follow-up check, with a reminder about migraine follow-up.
Reading the NU 631 Unit 2 rubric
A Herzing rubric for contraception counseling usually rewards patient-centered assessment, eligibility, presentation of options, informed decision making, plan and documentation. Patient-centered points go to recording priorities before recommending anything. Eligibility often carries heavy weight, and graders check that the correct criteria version and categories are applied. Options are credited when effectiveness is given as typical-use figures with sources and side effects are discussed honestly. Informed decision points depend on the patient's questions being answered and her choice recorded. Plan points require timing, backup contraception and follow-up. Documentation is scored on a clear record format, accurate terms and APA citations, and many markers credit the use of the patient's own priorities to explain the final choice.
NU 631 Unit 2 help: mistakes that cost points
Contraception records often lose points when the clinician recommends a method before learning what the patient wants. Students also misapply eligibility, for example allowing combined hormonal methods with migraine with aura. Effectiveness figures are commonly given as perfect use, which overstates protection. Side effects are sometimes minimized, which undermines informed choice. Another gap is missing backup contraception or timing details in the plan. Some records cite an older version of the eligibility criteria. Leaving out her questions hides the two-way nature of the counseling. Finally, avoid steering language; describe options and let the record show how the patient's priorities led to her decision.
Get a NU 631 Unit 2 example written to your instructions
Send the Unit 2 instructions and the rubric from your NU 631 classroom, plus the patient case your record covers. We write a custom example that establishes her priorities, applies a named eligibility set and documents her decision, returned in 24 to 48 hours. The first custom sample is free.
More NU 631 papers and FNP samples
- NU 631 Unit 1: Well-woman visit plan
- NU 631 Unit 3: Preconception counseling plan
- NU 631 Unit 4: Prenatal care plan
- NU 631 Unit 5: Abnormal screening result algorithm
- NU 631 Unit 6: Menopause management plan
- NU 631 Unit 7: Safety screening and response protocol
- NU 631 Unit 8: Maternal morbidity case review
- NU 621 Unit 2: Discussion post
- NU 636 Unit 2: Prescribing rationale
- NU 623 Unit 2: Risk stratification write-up
- NU 627 Unit 2: Functional and cognitive screening review
NU 631 Unit 2 questions, answered
Why start with the patient's priorities?
Because they determine which conversation is useful. A patient for whom bleeding changes are unacceptable and one for whom effectiveness dominates need different discussions, and opening with the most effective methods regardless produces counseling that misses what she actually cares about. Ask what matters, record it in her words, and let the option list follow from it.
Which effectiveness figures should I quote?
Both, with typical use given prominence. The difference between perfect and typical use is substantial for methods requiring ongoing action and negligible for those that do not, and that contrast is precisely what a patient is deciding between. Quoting perfect use alone overstates what several methods will deliver for her.
How honest should I be about side effects?
Completely, especially about the common ones. Unscheduled bleeding in the first months is the most frequent reason methods get stopped, and a patient who was not warned experiences it as something going wrong. Naming what is likely, how long it usually lasts and what would warrant contact keeps her using a method that suits her.
Where can I find a free NU 631 Unit 2 sample paper?
The NU 631 Unit 2 counseling record is posted here in full and free, with her priorities, the eligibility categories, typical-use figures, her questions and the plan. For a record about another patient or condition, send the case and a custom version is prepared free, generally inside 48 hours.
Can someone with migraine with aura use birth control pills?
Combined estrogen-progestin methods are generally not recommended with migraine with aura because of stroke risk, a category 4 in the US MEC. Progestin-only methods, intrauterine devices and the implant are usually acceptable.