NRNP 6559 Week 3 Contraception Selection Note Example

Course	NRNP 6559 Advanced Primary Care of Women and Diverse Populations
Week	Week 3
Paper type	Contraceptive method selection note
Length	About 760 words, 5 pages
Format	APA 7 student paper
School	Walden University
Program	Master of Science in Nursing (MSN)
Updated	October 2026

Free sample paper for NRNP 6559 Week 3

Contraceptive Method Selection Note: Migraine With Aura, a New Topiramate Prescription, and a Levonorgestrel IUD

Student Name

College of Nursing, Walden University

NRNP 6559: Advanced Primary Care of Women and Diverse Populations

Instructor Name

Month Day, Year

What this page is doingThe title names both conditions that narrow her options and the method she chose. A reader can see at once that the note will run two eligibility checks, not one.

Contraceptive Method Selection Note: Migraine With Aura, a New Topiramate Prescription, and a Levonorgestrel IUD

What She Wants, Recorded First

Composite case. A 31-year-old woman, an elementary school music teacher, came to discuss contraception after her neurologist started a new medicine. Before any history was taken about what she can use, she was asked what she wants from a method. In her words: "Nothing I have to remember every day. If my periods could be lighter, that would be a bonus. And I absolutely cannot get pregnant on this new medicine; the neurologist was very clear about that." She is using condoms consistently for now and is in a relationship with one partner.

Aura, Dated and Described

Headaches since her teens, without aura until 3 years ago. Since then, about half of her migraines begin with a shimmering zigzag in one side of her vision that spreads over 15 to 20 minutes and resolves before the headache starts. No weakness, numbness, or speech change with the aura. Headaches 6 to 8 days a month over the past year, which led her neurologist to start topiramate for prevention 4 weeks ago, 25 mg nightly increasing to 50 mg twice daily. Previous contraception: a combined pill in her twenties, stopped at 28 for other reasons, before the aura began.

Other history: neither she nor any relative has had a blood clot in a vein; no hypertension, diabetes, or known heart disease. Nonsmoker. Menstrual: last period began 11 days ago; cycles every 27 to 29 days, 6 days of heavy flow with cramps. Gravida 0.

Objective

Blood pressure 116/74. Body mass index 24. Urine pregnancy test negative today. She has used condoms at every act of intercourse since her last period, which, with the negative test, makes it reasonably certain she is not pregnant under the CDC's practice recommendations (Curtis et al., 2024).

US MEC as a Table

Each method is listed with its category for migraine with aura and for certain anticonvulsants, the group that includes topiramate, in the CDC's 2024 eligibility criteria (Nguyen et al., 2024). Category 1 means no restriction; 2, benefits generally outweigh risks; 3, risks usually outweigh benefits; 4, unacceptable health risk.

Combined pill, patch, or ring: aura 4; anticonvulsant 3. Excluded.

Progestin-only pill: aura 1; anticonvulsant 3. Weakened by the interaction, and a daily pill is what she does not want.

Injectable medroxyprogesterone: aura 1; anticonvulsant 1. Eligible; visits every 3 months; bleeding irregular at first.

Etonogestrel implant: aura 1; anticonvulsant 2. Eligible, with a possible reduction in effectiveness from the interaction.

Levonorgestrel IUD: aura 1; anticonvulsant 1. Eligible; typically lighter periods.

Copper IUD: aura 1; anticonvulsant 1. Eligible; tends to make periods heavier, which she does not want.

What this page is doingThe table records both categories for every method, so the reader sees why estrogen drops out for aura and why two progestin-only options weaken because of topiramate. That second check is where notes most often lose points.

An Interaction That Narrows Further

The aura alone removes estrogen-containing methods, because estrogen adds to the risk of ischemic stroke already associated with migraine with aura. Topiramate then narrows the list further. As an enzyme-inducing anticonvulsant, it can lower hormone levels from pills and the implant, which is why the progestin-only pill falls to category 3 and the implant to category 2. The stakes of failure are also higher than usual: first-trimester topiramate use was associated with more than five times the odds of cleft lip with or without cleft palate in pooled case-control data (Margulis et al., 2012). Her need is for a method whose effectiveness does not depend on her remembering it or on her liver's handling of the hormone. The two IUDs and the injection meet that need; of those, only the levonorgestrel IUD also meets her wish for lighter periods.

Her Choice and the Plan

Her choice, in her words: "The hormonal IUD. It lasts, I don't have to think about it, and my periods might finally be manageable."

Placement: levonorgestrel 52 mg IUD placed today after counseling on cramping, expulsion, and bleeding changes. Because more than 7 days have passed since her period started, she was advised to use condoms or avoid intercourse for the next 7 days, following the CDC's recommendation for placement at this point in the cycle (Curtis et al., 2024).

Follow-up: string check visit in 6 weeks, or sooner for severe pain, fever, or unusual discharge. She was told the IUD does not interact with topiramate, and that if her neurologist changes her medicine, the IUD will not need to change.

Letter to her neurologist: that she has chosen and received a levonorgestrel IUD; that estrogen-containing methods were avoided because of migraine with aura; and that the method is not affected by topiramate or by other enzyme-inducing anticonvulsants, should a change be considered.

References

Curtis, K. M., Nguyen, A. T., Tepper, N. K., Zapata, L. B., Snyder, E. M., Hatfield-Timajchy, K., Kortsmit, K., Cohen, M. A., & Whiteman, M. K. (2024). U.S. selected practice recommendations for contraceptive use, 2024. MMWR Recommendations and Reports, 73(3), 1-77. https://doi.org/10.15585/mmwr.rr7303a1

Margulis, A. V., Mitchell, A. A., Gilboa, S. M., Werler, M. M., Mittleman, M. A., Glynn, R. J., & Hernandez-Diaz, S. (2012). Use of topiramate in pregnancy and risk of oral clefts. American Journal of Obstetrics and Gynecology, 207(5), 405.e1-405.e7. https://doi.org/10.1016/j.ajog.2012.07.008

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

NRNP 6559 Week 3 instructions, in plain terms

The third week of NRNP 6559 often asks for a contraceptive counseling or method selection note. You record the patient's goals first, take a history focused on eligibility, apply the US MEC to each option, check drug interactions, support the patient's choice and plan insertion or start. Faculty grade eligibility reasoning heavily. Cite the US MEC and Selected Practice Recommendations in APA 7. Migraine aura and medications are frequent test points. Patient preference should drive the final choice. Follow-up timing should be stated. NRNP 6559 faculty want the patient's goals recorded in her words first. Date and describe the aura. Show the US MEC category for each method in a table. Check the topiramate dose and its interaction. Support her choice with the plan for starting it.

Inside the NRNP 6559 Week 3 example

The subjective section records what she wants from a method before anything about what she can use: no daily pill, lighter periods if possible, and no pregnancy while taking a drug known to harm a fetus. Her migraine history follows in detail, including the visual aura that began three years ago, then the topiramate her neurologist started last month. Blood pressure, smoking status, and a pregnancy test are documented. The assessment works through the methods in a table, one row each, recording the US MEC category for migraine with aura and the category for her anticonvulsant, so a reader sees why estrogen-containing methods drop out and why some progestin-only options weaken. Her choice, a levonorgestrel IUD, is recorded in her words, with backup contraception, follow-up, and a note to her neurologist in the plan.

Reading the NRNP 6559 Week 3 rubric

The eligibility reasoning carries this note's clinical credit, and it is most often lost by recording migraine without asking about aura, then offering a combined pill. Graders in women's health read that as a safety error, because the distinction is exactly what the CDC criteria turn on. This example documents the aura and shows the resulting category. A second, subtler deduction goes to notes that pass the eligibility check and skip the interaction check, missing a drug her neurologist prescribed. Counseling is graded as well: a method chosen for her rather than with her, or recorded without her stated priorities, costs points in a course that asks for person-centered care. Start-up details matter less but still count, and a plan without backup contraception or follow-up leaves them uncollected.

Common NRNP 6559 Week 3 mistakes, and how to avoid them

Contraception notes lose the most when migraine is recorded without asking about aura and a combined method is offered. Ask and record. Another common gap is ignoring enzyme-inducing drugs like topiramate at higher doses. Check the interaction. Writers also choose the method for the patient. Record her goals first. Avoid listing MEC categories without explaining them. Use a table. Keep the aura description specific. Close with the insertion plan and follow-up. Writers also forget backup contraception while waiting for insertion. Mention it. Another frequent slip is ignoring topiramate's teratogenic risk, which makes reliable contraception more important. Note it. Keep the MEC categories correct for the current edition. Close with follow-up after insertion.

Get a NRNP 6559 Week 3 example written to your instructions

Share your Week 3 case and its rubric, plus any drug list the case supplies. In the note that follows, each method is weighed against her stated priorities, US MEC is applied condition by condition, interactions are checked, and the start-up plan is recorded. Your first custom sample is free and arrives in 24-48 hours.

More NRNP 6559 papers and MSN samples

NRNP 6559 Week 3 questions, answered

What is US MEC?

The U.S. Medical Eligibility Criteria for Contraceptive Use, published by the CDC, which assigns each method a category for each medical condition, from no restriction through unacceptable risk. It is the standard reference for whether a method is safe for a given history. The example applies it condition by condition in a table and names the category rather than paraphrasing it.

Why does migraine with aura matter so much?

Because estrogen-containing methods add stroke risk, and migraine with aura is associated with stroke risk of its own, so US MEC treats combined hormonal contraception as unacceptable for women with aura. Migraine without aura is handled differently. A note that records migraine but never asks about aura cannot make this distinction, and so the example documents the aura's onset and character.

What if my case involves a different medication?

The interaction column changes; the approach does not. Enzyme-inducing drugs, some antiretrovirals, and certain antibiotics each have their own entries in the CDC guidance, and the finished sample checks whatever your case lists against them. Send the full medication list with the prompt, and the table is built from your patient's conditions rather than from this invented one's.

Where can I find a free NRNP 6559 Week 3 sample paper?

The migraine with aura contraception note is printed here with her goals, the aura history, the US MEC table, the topiramate interaction and her choice.

Which drug narrows the choice in NRNP 6559 Week 3?

Topiramate, newly started by her neurologist, which can reduce the effectiveness of some hormonal methods.