A nurse is educating a client who is 23 weeks pregnant about immunizations.
Which statement should the nurse include in the teaching?
You can receive an influenza vaccination during pregnancy.
You should not receive the rubella vaccine while breastfeeding.
You should receive a varicella vaccine before you deliver.
You cannot receive the Tdap vaccine until after you deliver.
The Correct Answer is A
Choice A rationale
The nurse should include in the teaching that a client who is 23 weeks pregnant can receive an influenza vaccination during pregnancy. This is because the influenza vaccine is safe and recommended for pregnant women to protect both the mother and the baby from the flu.
Choice B rationale
The rubella vaccine is a live vaccine and is not recommended during pregnancy or while breastfeeding due to the potential risk to the baby. However, it can be given immediately after delivery if the woman is not immune.
Choice C rationale
The varicella vaccine is also a live vaccine and is not recommended during pregnancy. It should be given before pregnancy or immediately after delivery if the woman is not immune.
Choice D rationale
The Tdap (Tetanus, Diphtheria, Pertussis) vaccine is actually recommended during each pregnancy, regardless of the patient’s previous history of receiving the vaccine. The optimal timing for Tdap administration is between 27 and 36 weeks of gestation.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale
Aspirin is not typically recommended for cramps following a D&C. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are usually suggested for pain relief. Aspirin can increase the risk of bleeding, which is not desirable after a surgical procedure like a D&C2.
Choice B rationale
Products of conception will not be present in vaginal bleeding after a D&C. The purpose of a D&C is to remove tissue from the uterus, including any remaining products of conception following a miscarriage.
Choice C rationale
While a balanced diet is always important, there’s no specific recommendation for an increased intake of zinc-rich foods following a D&C. Good nutrition can support healing, but there’s no need to focus specifically on zinc.
Choice D rationale
Vaginal intercourse can be resumed after 2 weeks following a D&C. This allows time for the cervix to close and any post-procedure bleeding to stop. It’s also important to prevent infection.
Correct Answer is A
Explanation
Choice A rationale
A 38-year-old client who reports smoking one pack of cigarettes every day. Oral contraceptives are contraindicated in women who are over 35 years old and smoke. This is because the combination of oral contraceptives and smoking increases the risk of serious cardiovascular side effects, such as blood clots, stroke, or heart attack. These risks are even higher in women over 35 years old who smoke. Therefore, this client should not receive oral contraceptives due to the increased risk of these serious side effects.
Choice B rationale
A 28-year-old client who has a history of pelvic inflammatory disease. While pelvic inflammatory disease (PID) can lead to complications such as infertility and ectopic pregnancy, it is not a contraindication for the use of oral contraceptives. In fact, oral contraceptives can provide some protection against PID by causing changes in the cervix that make it more resistant to infection.
Choice C rationale
A 32-year-old client who has benign breast disease. Benign breast disease is not a contraindication for the use of oral contraceptives. While some studies have suggested a slightly increased risk of breast cancer in women who have used oral contraceptives, the risk appears to decrease over time once the contraceptives are stopped.
Choice D rationale
A 26-year-old client who has migraine headaches at the start of each menstrual cycle. While migraines can be a contraindication for the use of oral contraceptives, it generally applies to migraines with aura. Women who have migraines with aura have an increased risk of stroke when using oral contraceptives. However, for women who have migraines without aura, the benefits of using oral contraceptives usually outweigh the risks.
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