A nurse is reviewing the laboratory report for a client who is in active labor. The client tested positive for group B streptococcus B-hemolytic. Which of the following medications should the nurse plan to administer to the client?
Doxycycline.
Cefotetan.
Ampicillin.
Fluconazole.
The Correct Answer is C
The correct answer is c. Ampicillin.
Rationale:
- Group B Streptococcus (GBS) B-hemolytic is a bacterium that can colonize the vagina and rectum of pregnant women. While usually harmless to the mother, it can be passed to the newborn during birth and cause serious infections, including pneumonia, meningitis, and sepsis.
- Ampicillin is the first-line antibiotic recommended by the Centers for Disease Control and Prevention (CDC) for the prevention of GBS disease in newborns. It belongs to the penicillin class of antibiotics, which are highly effective against GBS and generally well-tolerated by pregnant women and newborns.
- Doxycycline is not recommended for GBS prophylaxis due to its poor penetration into amniotic fluid and potential for causing tooth discoloration and bone development problems in newborns.
- Cefotetan is an alternative option for women with penicillin allergy, but ampicillin is still preferred due to its lower cost and broader spectrum of activity against GBS strains.
- Fluconazole is an antifungal medication and has no activity against GBS bacteria.
Detailed Rationale for Each Choice:
a. Doxycycline:
- Rationale against:
- Poor penetration into amniotic fluid: Doxycycline does not effectively reach the amniotic sac, where the baby is surrounded, and therefore may not adequately protect the newborn from GBS infection.
- Adverse effects in newborns: Doxycycline can cause tooth discoloration and bone development problems in infants exposed in utero.
b. Cefotetan:
- Rationale for:
- Alternative for penicillin allergy: Cefotetan is a cephalosporin antibiotic effective against GBS and can be used in women with penicillin allergy.
- Rationale against:
- Second-line option: Ampicillin is the preferred choice due to its lower cost and broader spectrum of activity against GBS strains.
c. Ampicillin:
- Rationale for:
- First-line antibiotic: Ampicillin is the CDC-recommended first-line antibiotic for GBS prophylaxis due to its:
- High effectiveness against GBS: Ampicillin has a broad spectrum of activity against GBS strains.
- Good safety profile: Ampicillin is generally well-tolerated by pregnant women and newborns.
- Cost-effectiveness: Ampicillin is a relatively inexpensive antibiotic compared to other options.
- First-line antibiotic: Ampicillin is the CDC-recommended first-line antibiotic for GBS prophylaxis due to its:
d. Fluconazole:
- Rationale against:
- Antifungal medication: Fluconazole is an antifungal medication and has no activity against GBS, which is a bacterium.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Swaddling the baby tightly with his legs extended before laying him down to sleep is not a recommended practice, as it can increase the risk of hip dysplasia. Instead, the baby should be placed on their back in a safe sleep environment.
Choice B rationale:
This statement is correct because monitoring the baby's urinary output is essential in ensuring adequate hydration and proper kidney function. Less than six wet diapers a day could be a sign of dehydration and should be promptly reported to the pediatrician.
Choice C rationale:
It is not necessary to retract the foreskin to clean the baby's penis during each bath. The foreskin should be left alone and not forcibly retracted until it naturally loosens, usually around the age of 3 to 5 years.
Choice D rationale:
Applying triple antibiotic ointment on the baby's umbilical cord is not recommended, as the standard practice is to keep the umbilical cord clean and dry. This helps it to fall off naturally within a week or two after birth, reducing the risk of infection.
Correct Answer is D
Explanation
Choice A rationale:
To calculate the estimated date of delivery using Nägele's Rule, subtract three months from the first day of the last menstrual period (August 10), and then add seven days. However, choice A (May 20) is incorrect because it adds eight days instead of seven.
Choice B rationale:
It does not add seven days to the calculation.
Choice C rationale:
It adds three days instead of seven to the calculation
Choice D rationale:
It follows the correct application of Nägele's Rule. Subtracting three months from August 10 gives us May 10, and then adding seven days gives us May 17as the estimated date of delivery.
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