| Course | NU680 Gynecological, Reproductive, and Sexual Health |
|---|---|
| Unit | Unit 3 |
| Paper type | Contraceptive counseling plan |
| Length | About 950 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | MSN |
| Updated | October 2026 |
Free sample paper for NU680 Unit 3
Lupus, a Positive Lupus Anticoagulant and Heavy Periods: A Unit 3 Contraceptive Counseling Plan Where Two Guidelines Disagree
[Student Name]
Purdue University Global
NU680: Gynecological, Reproductive, and Sexual Health
Unit 3 Contraceptive Counseling Plan
[Instructor Name]
[Date]
The patient is composite; the sources cited are real.
The Patient and Her Goals
Ms. Lindqvist was diagnosed with lupus four years ago after joint pain, a malar rash and protein in her urine. Her disease has been quiet for eighteen months on hydroxychloroquine 400 milligrams daily. Lupus anticoagulant has been positive on two tests twelve weeks apart; she has never had a clot or a pregnancy loss. Her platelet count, kidney function and blood pressure are normal. She does not smoke. Her bleeding runs a full week, and at its peak she changes a super tampon every two hours.
She and her partner use condoms most of the time. She wants to delay pregnancy until her rheumatologist agrees her disease has been stable long enough, probably about two years from now, and she wants a method she does not have to think about at work. Her sister takes a combined pill and likes it.
Why Combined Methods Are Ruled Out
Every combined method, whether taken as a pill, worn as a patch or inserted as a ring, contains estrogen, which raises the risk of venous and arterial thrombosis. Antiphospholipid antibodies raise that risk independently. The U.S. Medical Eligibility Criteria assign combined methods category 4, an unacceptable health risk, for lupus with positive or unknown antiphospholipid antibodies (Nguyen et al., 2024). The American College of Rheumatology guideline reaches the same conclusion and strongly recommends against estrogen-containing methods for any patient who is antibody positive (Sammaritano et al., 2020). Her sister's pill is not an option for her, and the plan says so plainly but without alarm, because she has no clot history and the risk is avoidable.
The method that suits her sister would be the most dangerous one on her list.
Where the Guidelines Differ
For progestin-only methods the two documents diverge. The CDC criteria place the levonorgestrel IUD, the implant, the progestin-only pill and the injection in category 3 for antibody-positive lupus, meaning the theoretical or proven risks usually outweigh the advantages, while the copper IUD is category 1 (Nguyen et al., 2024). The rheumatology guideline, written from the experience of clinicians who manage these patients, recommends the levonorgestrel IUD, the copper IUD or the progestin-only pill for antibody-positive patients and recommends against only the injection, because medroxyprogesterone has been linked to thrombosis and also lowers bone density (Sammaritano et al., 2020).
The difference reflects the evidence base. The levonorgestrel IUD releases a small amount of hormone, mostly acting on the uterus, and studies have not shown a meaningful rise in clot risk with it. Category 3 is not a prohibition; it asks for clinical judgment and a method that offers advantages the alternatives lack. For Ms. Lindqvist, that advantage is real.
The Options, Ranked for Her
Levonorgestrel 52-milligram IUD. It is more than 99 percent effective, lasts up to eight years for contraception and reduces menstrual blood loss substantially, often ending periods altogether within a year. It addresses both her goals. The guideline disagreement is discussed with her and her rheumatologist, and the choice is documented as a shared decision.
Copper IUD. It is equally effective, hormone free and category 1 under both documents. Its main drawback for her is that it commonly makes periods heavier and more painful, which matters with bleeding already this heavy.
Progestin-only pill. It is acceptable to the rheumatology guideline but must be taken every day, which she does not want, and its typical-use failure rate is far higher than either IUD.
Implant. It is very effective, but the rheumatology guideline does not list it among its recommended methods for antibody-positive patients, and its unpredictable bleeding would not help her heavy periods.
Injection. Both documents advise against it for her.
The Counseling Conversation
The visit uses shared decision making. The clinician explains each method's effectiveness first, then how it fits her lupus, then side effects. Ms. Lindqvist asks whether the IUD will interfere with getting pregnant later; she is told that fertility returns promptly after removal, so it fits a two-year plan. She asks whether insertion will hurt; the clinician describes the cramping, offers a paracervical block and suggests timing insertion during her period. She chooses the levonorgestrel IUD. Her rheumatologist, contacted by message with her permission, agrees.
Practical Steps
The U.S. Selected Practice Recommendations allow an IUD to be placed at any time if pregnancy can reasonably be excluded, with a week of backup protection after a hormonal IUD unless it goes in during the first week after her period starts (Curtis et al., 2024). Her insertion is booked for the third day of her next period, which removes the need for backup. Condoms are still recommended for infection protection if she has a new partner.
A follow-up visit at six weeks checks strings, bleeding and satisfaction. She hears that unpredictable spotting through roughly half a year is expected, while severe pelvic pain, fever or a missing string should prompt a call.
Emergency Contraception
Because she uses condoms until insertion, she is given information about emergency contraception. Levonorgestrel or ulipristal pills do not carry the thrombotic risk of daily estrogen and can be used if a condom fails before her appointment.
Planning Ahead
Her preconception plan is noted for two years from now: disease quiet for at least six months before trying, a medication review, low-dose aspirin and possibly heparin during pregnancy given her antibodies, and early referral to maternal-fetal medicine. The IUD buys time to prepare for that pregnancy safely.
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
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
Sammaritano, L. R., Bermas, B. L., Chakravarty, E. E., Chambers, C., Clowse, M. E. B., Lockshin, M. D., Marder, W., Guyatt, G., Branch, D. W., Buyon, J., Christopher-Stine, L., Crow-Hercher, R., Cush, J., Druzin, M., Kavanaugh, A., Laskin, C. A., Plante, L., Salmon, J., Simard, J., Somers, E. C., Steen, V., Tedeschi, S. K., Vinet, E., White, C. W., Yazdany, J., Barbhaiya, M., Bettendorf, B., Eudy, A., Jayatilleke, A., Shah, A. A., Sullivan, N., Tarter, L. L., Birru Talabi, M., Turgunbaev, M., Turner, A., & D'Anci, K. E. (2020). 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases. Arthritis Care & Research, 72(4), 461-488. https://doi.org/10.1002/acr.24130
What the NU680 Unit 3 assignment asks for
The third unit typically presents a patient whose medical history narrows the contraceptive choices and asks for a counseling plan. Prompts usually expect the eligibility category of each method under the current U.S. Medical Eligibility Criteria, a ranked set of options for the patient, a description of the counseling conversation and practical steps such as timing and backup. Many sections also want the patient's goals stated first, since the plan should serve them. When a specialty guideline addresses the condition, as rheumatology does for lupus, instructors reward students who compare it with the CDC criteria rather than citing one alone. Most rubrics fit a headed plan of a few APA pages, often with a short table of methods and their categories. Current editions matter, because the criteria and the practice recommendations were both revised in 2024.
How this NU680 Unit 3 example is built
The Lindqvist plan records her diagnosis, antibody results, bleeding pattern and goals before any method is named. The next section rules out the pill, patch and ring with the CDC category 4 and the rheumatology guideline's strong recommendation, under a highlighted line about her sister's pill. A section on disagreement then sets the CDC's category 3 for progestin methods beside Sammaritano and colleagues' preference for the hormonal IUD, and a margin note explains what category 3 actually permits. Five options are ranked for her, from the levonorgestrel IUD to the injection both documents advise against. The counseling conversation answers her questions about fertility and insertion pain. Practical steps cite Curtis and colleagues for insertion timing, with condoms kept for infection protection. Emergency contraception and a preconception outline close the plan.
NU680 Unit 3 rubric: what earns full points
For this contraception unit the marks follow the accuracy of eligibility categories, fit to the patient, quality of counseling, practical detail and writing. Accuracy is checked closely: a wrong category, or one quoted from an outdated edition, costs marks quickly. Fit to the patient rewards plans that rank methods against her stated goals and her other conditions, such as heavy bleeding. Counseling credit goes to a described conversation, including the patient's questions and how they were answered, which shows shared decision making in practice. Practical detail, covering timing, backup, follow-up and warning signs, distinguishes a plan from a summary. When guidelines conflict, graders reward a reasoned resolution with documentation rather than silence about the conflict. Clear headings, an optional method table and APA references for each guideline complete the criteria in most sections.
NU680 Unit 3 help: mistakes that cost points
Plans lose the most marks when they recommend an estrogen method to a patient whose condition makes estrogen unsafe, often because the student checked the condition but not the antibody status. Another common gap is citing the CDC criteria without the year, or using categories from the 2016 edition. Some plans present one method as the answer without the alternatives the patient deserves to hear. Others describe counseling in a sentence, leaving out the patient's own questions. Backup contraception and emergency contraception are often forgotten. If your patient's condition has its own specialty guideline, read its contraception section and compare it with the CDC table before drafting. A short table of each method, its category and your reason is a reliable starting point. Send the case and your section's prompt, and a plan can be built around that patient.
Get an NU680 Unit 3 example written to your instructions
Send the patient case, the medical conditions your prompt lists and the unit instructions with the rubric. A custom plan checks each method against the current eligibility criteria and builds counseling around what the patient wants. Turnaround is 24-48h, with the first one free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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- NU680 Unit 5: Seminar Reflection
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- NU680 Unit 7: Diagnostic Reasoning Paper
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- NU680 Unit 9: Policy Brief
- NU680 Unit 10: Inclusive Care Plan
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- NU678 Unit 3: Discussion Post, Direct Observation
- MN502 Unit 3: Grand Theory Review
- NU677 Unit 3: Consent and Assent, Divided Parents
NU680 Unit 3 questions, answered
Do I need to cite the eligibility category for every method?
For the methods you discuss, yes. Citing the category shows you checked the current edition and makes your reasoning easy to follow. A small table with each method, its category and a reason works well in most sections.
What if the patient prefers a method the criteria advise against?
Explain the risk plainly and offer the safest methods that meet her goals. The plan should respect her choice while documenting the counseling. Many rubrics reward a respectful explanation of risk more than a flat refusal.
Is a backup method part of the counseling plan?
Often, yes. Starting a new method may require backup for a few days, and some patients need condoms for infection protection regardless. Mentioning both shows complete counseling.
Where can I find a free NU680 Unit 3 sample paper?
You can read the complete NU680 Unit 3 contraceptive counseling plan on this page. It counsels a composite 27-year-old with lupus and antiphospholipid antibodies, rules out estrogen methods and resolves a disagreement between the CDC criteria and the rheumatology guideline.
Why does the NU680 Unit 3 sample choose the hormonal IUD over the copper IUD?
Both are highly effective, but the copper IUD often makes periods heavier, and her periods were already very heavy. The levonorgestrel IUD reduces bleeding, and the rheumatology guideline supports it for antibody-positive patients.