QuestionSBA
QuestionChoice
As this woman is in the last week of her cycle, likely, ovulation has already been prevented. Furthermore, no history of unprotected sexual intercourse (UPSI) is mentioned.
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b
Offer an emergency contraception such as the Ella one pill
QuestionChoice
This is the best option to prevent pregnancy for this woman as she is in the final week of her cycle (as she only has five pills left in the packet). Likely, ovulation has already been prevented for this cycle. However, it is important for the next cycle, hence starting the next pack immediately after.
10027731
a
Take the last pill that was missed, finish the current pack and start the next pack immediately after
QuestionChoice
There is no mention of unprotected sexual intercourse (UPSI) in this time of missed pills. Furthermore, ovulation was likely already prevented as this woman is in the last week of her cycle.
10027734
d
Offer an immediate pregnancy test
QuestionChoice
The priority for this woman is maintaining the pill's effectiveness for her next cycle. Ovulation was likely already prevented before her sickness so barrier contraception is not needed. However, to maintain the effectiveness for her next cycle, it is important she takes the last missed pill as soon as possible and then starts the next pack immediately after finishing this one.
10027733
c
Carry on with pills as normal and use barrier contraception in the pill-free week
QuestionChoice
This is a form of emergency contraception, which is not needed in this case. Ovulation was likely already prevented before the missed pills. It is more important to maintain effective contraception for the next cycle. This woman may want to switch to another form of contraception if she is consistently struggling to take pills at the same time each day but this is not the most important step at the moment.
10027735
e
Switch to a copper IUD
Concept
Chapter
2693
5999
Missed oral contraceptive pills
Topic
162
General practice
17944
A 21-year-old is asking for advice about her oral contraceptive pill. For the past few days, she has been vomiting. She thinks this started after eating a "dodgy" takeaway. As she has been vomiting she has not been able to keep any food or drink down, including her combined oral contraceptive pill. Further questioning reveals she has missed three days of her pill. She also tells you she has only five pills left in the current pack and has taken the pills correctly for this cycle. She has not had any intercourse since her last withdrawal bleed, and now feels recovered and no longer feels nauseous. 

What is the most appropriate advice to give her?
a