GR is a 31-year-old woman who wants to start a family. She has been on birth control pills for 10 years and wants information about ovulation, ovulation kits, and tips for conceiving. The doctor will discuss this information with her and her husband at a follow-up appointment. Ovulation occurs when an egg is released and travels through the fallopian tubes, ready to be fertilized. Hormone levels regulate the process of follicle development and egg release. The doctor recommends GR complete her current pack of birth control and wait 3 months after stopping before trying to conceive to regulate her cycle. Lifestyle changes like reducing caffeine, weight loss, and avoiding toxins are also advised.

19. Health Care Problem Priority Therapeutic Goals Recommendations for Therapy Monitoring Parameters and Endpoint Preconception Primary Proper discontinuation of oral contraceptive. Overall good health. Discontinue Ortho Novum 7/7/7 at least three months before conceiving, but discontinue after completing the current pack. Begin taking 400mcg folic acid once daily, again, three months prior to conceiving. Limit caffeine intake. (<300mg daily) Avoid smoke, alcohol, and illicit substances. Follow up with patient in one month to ensure she has followed the recommendations listed and to ask if she has any further questions. Obesity Secondary to health conception Maintain BMI of less than or equal to 26 kg/m2. Maintain a healthy diet with the required nutrients needed for conception such as 400 mcg of folic acid daily. Exercise at least 30 minutes daily 5 days a week. See a nutritionist for optimal diet for preconception. Join a program such a Weight Watchers for support. Keep a food journal to assess food choices made. Weekly weight checks to assess progress. Weight loss should be about one pound per week. Endpoint should be a BMI of equal to or less than 26 kg/m2 before conception.