A nurse is planning care for a client who is pregnant and has HIV. Which of the following actions should the nurse include in the plan of care?
Instruct the client to stop taking the antiretroviral medications at 32 weeks of gestation.
Use a foetal scalp electrode during labor and delivery
Bathe the newborn before initiating skin-to-skin contact.
Administer a pneumococcal immunization to the newborn within 4 hr following birth.
The Correct Answer is C
Pregnant clients with HIV require comprehensive care during pregnancy, delivery, and postpartum periods to prevent transmission of HIV to the newborn. Bathing the newborn before initiating skin-to-skin contact is a recommended action to reduce the risk of HIV transmission from mother to child. This practice helps to remove any maternal blood or other bodily fluids from the newborn's skin, which may contain the virus. Therefore, the nurse should instruct the client to bathe the newborn before initiating skin-to-skin contact.
Antiretroviral medications are usually continued throughout pregnancy and during labor and delivery to decrease the risk of transmission to the newborn. Therefore, the nurse should not instruct the client to stop taking antiretroviral medications at 32 weeks of gestation, as mentioned in option a.
Fetal scalp electrode is a device that ataches to the baby's scalp to monitor the fetal heart rate. This device can cause small cuts or abrasions on the baby's scalp, which may increase the risk of HIV transmission.
Therefore, its use should be avoided in clients with HIV. Therefore, option b is not a recommended action.
Administering pneumococcal immunization to the newborn within 4 hours following birth is not a recommended action in the plan of care for a client who is pregnant and has HIV. Pneumococcal immunization is not indicated for newborns immediately after birth. Therefore, option d is not a recommended action.
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Correct Answer is D
Explanation
Cytomegalovirus (CMV) is a common virus that can cause serious health problems in newborns if the mother acquires a primary infection during pregnancy and passes the virus to the developing fetus. CMV can be transmited transplacentally or during delivery through contact with infected body fluids.
Newborns who acquire CMV transplacentally may exhibit a range of symptoms, including jaundice, hepatosplenomegaly, thrombocytopenia, microcephaly, and hearing loss. Of the options listed, only hearing loss is consistent with a congenital CMV infection.
Macrosomia (option a) refers to a condition in which a baby is born larger than average for gestational age. It is not typically associated with a congenital CMV infection.
Cataracts (option b) are a clouding of the lens of the eye and are not typically associated with a congenital CMV infection.
Urinary tract infection (option c) is a possible complication of a congenital CMV infection, but hearing loss is a more common and specific finding.
Correct Answer is B
Explanation
Postpartum haemorrhage (PPH) is defined as excessive bleeding following the birth of a baby. It is a major cause of maternal morbidity and mortality worldwide. Risk factors for PPH include uterine atony, retained placental fragments, genital tract trauma, coagulopathy, and previous history of PPH.
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