A female adolescent with pelvic inflammatory disease (PID) is admitted to the hospital after 14 days of taking levofloxacin 500 mg by mouth (PO) once daily and metronidazole 500 mg PO twice daily.
She asks the nurse, “Why do I have to be in the hospital? Why can’t I get my treatment at home?” What purpose should the nurse provide that supports an effective outcome?
Implementation of contact precautions to prevent spread of infection.
Administration of a supervised parenteral antibiotic protocol.
Detection of early symptoms of Jarisch-Herxheimer reaction.
Collection of serial anaerobic cultures of vaginal discharge.
The Correct Answer is B
Choice A rationale
While contact precautions can be important in managing some infections, they are not the primary reason for hospitalization in the case of PID891011.
Choice B rationale
Hospitalization for PID is often recommended for the administration of a supervised parenteral antibiotic protocol. This allows for the direct administration of antibiotics into the bloodstream, which can be more effective in severe cases.
Choice C rationale
The Jarisch-Herxheimer reaction is a reaction to endotoxin-like products released by the death of harmful microorganisms within the body during antibiotic treatment. It is not a primary reason for hospitalization in the treatment of PID891011.
Choice D rationale
While the collection of serial anaerobic cultures of vaginal discharge can be part of the diagnostic process for PID, it is not the primary reason for hospitalization.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is A. Praise the client for her actions and offer to discuss ways to decrease consumption even more.
Why? During pregnancy, any amount of alcohol poses a risk to the developing fetus, but abruptly shaming or forcing action may not be effective. The best approach is motivational interviewing, which involves acknowledging the client's reduction while encouraging further progress. A supportive conversation can help guide the client toward complete cessation of alcohol use.
Here’s why the other options are incorrect:
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B. Insist that the client stop all alcohol use and draw a blood alcohol level at each prenatal visit – While alcohol cessation is the goal, forcing the client without a supportive approach can lead to resistance. Routine blood alcohol testing is not standard unless substance dependence is suspected.
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C. Notify child protective services of the client’s illicit drug use and probable child endangerment – Alcohol is not classified as an illicit drug, and reporting at this stage would be premature unless clear evidence of abuse or harm to the fetus exists.
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D. Refer the client to an outpatient alcohol abuse program for disulfiram therapy – Disulfiram (Antabuse) is not recommended in pregnancy, as it may cause adverse effects. Instead, behavioral counseling and support groups are preferred interventions.
Correct Answer is D
Explanation
Choice A rationale
While multiple gestation can cause an increase in maternal serum alpha-fetoprotein (MS-AFP) levels, it is not the most likely cause of an elevated MS-AFP level at 17 weeks.
Choice B rationale
Fetal hypoxia, or lack of oxygen to the fetus, is not typically associated with an increase in MSAFP levels.
Choice C rationale
Down syndrome is typically associated with lower, not higher, levels of MS-AFP891011.
Choice D rationale
An elevated level of MS-AFP at 17 weeks is most commonly associated with a neural tube defect. Neural tube defects are birth defects of the brain, spine, or spinal cord that occur during the first month of pregnancy.
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