A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate. Which of the following clinical findings should the nurse instruct the client to report?

Group B Streptococcus β-hemolytic (GBS) is a type of bacteria that can cause serious infections in newborns, such as sepsis, pneumonia, and meningitis. GBS can be transmitted from the mother to the baby during labor and delivery if the mother is colonized with GBS in her vagina or rectum¹.
To prevent GBS infection in newborns, pregnant women who test positive for GBS or have risk factors for GBS should receive intravenous (IV) antibiotics during labor. The antibiotics can reduce the amount of GBS bacteria in the mother's body and lower the chance of passing them to the baby¹².
The recommended antibiotic for GBS prophylaxis is penicillin, which is safe and effective for most women. However, some women may be allergic to penicillin and need an alternative antibiotic. Ampicillin is one of the alternative antibiotics that can be used for GBS prophylaxis in women who have a mild allergy to penicillin (such as rash or itching). Ampicillin is also a type of penicillin, but it has a slightly different structure and may not cause an allergic reaction in some people²³.
Therefore, the nurse should plan to administer ampicillin to the client who tested positive for GBS and has a mild allergy to penicillin. The nurse should also monitor the client for any signs of anaphylaxis (a severe allergic reaction) and have epinephrine ready in case of emergency²³.

The other options are not medications that the nurse should administer to the client:
- a) Cefotetan is another alternative antibiotic that can be used for GBS prophylaxis in women who have a severe allergy to penicillin (such as anaphylaxis or angioedema). However, it is not indicated for women who have a mild allergy to penicillin, as it may still cause cross-reactivity and an allergic reaction²³.
- b) Fluconazole is an antifungal medication that is used to treat fungal infections, such as candidiasis (thrush) or cryptococcal meningitis. It is not effective against bacterial infections, such as GBS, and it is not indicated for GBS prophylaxis⁴.
- d) Doxycycline is an antibiotic that is used to treat bacterial infections, such as chlamydia, gonorrhea, or Lyme disease. It is not effective against GBS and it is not indicated for GBS prophylaxis. Moreover, doxycycline is contraindicated in pregnancy, as it can cause harm to the fetus, such as tooth discoloration or bone growth problems.

When reviewing infection control procedures in a newborn nursery, the nurse manager should instruct the newly hired nurses to place newborn bassinets at least 3 feet apart. This practice helps prevent the spread of infections between infants by minimizing close contact and reducing the risk of droplet transmission.

Option a) Maintaining airborne precautions in the nursery is not necessary unless there is a specific airborne infectious disease outbreak or a newborn with a known airborne infection. Standard precautions, including hand hygiene and proper use of personal protective equipment, are generally sufficient to prevent the spread of infections in a newborn nursery.

Option b) Placing the newborn's foot on a sterile field during a heelstick is not necessary for routine procedures. However, a clean and disinfected surface should be used to perform the heelstick to minimize the risk of introducing pathogens. Sterile fields are typically reserved for sterile procedures in an operating room or other controlled environments.

Option d) Allowing parents to enter the nursery if they are wearing a mask is not a standard infection control practice. In general, only authorized personnel should enter the nursery, and parents or visitors should follow any specific visiting policies in place. If there are concerns about respiratory infections or outbreaks, additional visitor restrictions or requirements may be implemented.