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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.

Answer and Explanation

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.

d. Fluconazole:

Rationale against:
- Antifungal medication: Fluconazole is an antifungal medication and has no activity against GBS, which is a bacterium.

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Correct Answer is D

Explanation

Choice A rationale:

Intense contractions lasting 45 to 60 seconds are normal during labour and indicate effective uterine activity. This finding does not warrant immediate reassessment.

Choice B rationale:

Progressive sacral discomfort during contractions can be a normal part of labour as the baby descends into the birth canal. It does not necessarily indicate a need for reassessment.

Choice C rationale:

A sense of excitement and warm, flushed skin can be a common emotional and physiological response during labour, particularly as the woman reaches the final stages of delivery. This finding does not necessarily require immediate reassessment.

Choice D rationale:

"An urge to have a bowel movement during contractions”. is the correct answer because it could be an indication that the client is experiencing the urge to push, which means the baby's head is descending and nearing delivery. The nurse should reassess the client promptly to determine if she is fully dilated and ready to push.

A. Avoid using lotion or ointment on the newborn's skin. B. Dress the newborn in lightweight clothing. C. Keep the newborn supine throughout treatment. D. Measure the newborn's temperature every 6 hr.

Correct Answer is A

Explanation

Choice A rationale:

When a newborn is receiving phototherapy for hyperbilirubinemia, it is essential to avoid using lotions or ointments on the skin. Phototherapy works by breaking down bilirubin in the skin, and any barriers like lotions or ointments can interfere with this process. The baby's skin needs to be exposed to the light to effectively reduce bilirubin levels.

Choice B rationale:

Dressing the newborn in lightweight clothing is a correct action during phototherapy. The baby should be undressed and placed under the phototherapy lights, with only a diaper on to maximize skin exposure to the light.

Choice C rationale:

Keeping the newborn supine throughout treatment is not a recommended action during phototherapy. To optimize skin exposure to the light, the baby should be placed in a prone position, with the back exposed to the light source.

Choice D rationale:

Measuring the newborn's temperature every 6 hours is essential, but it is not directly related to phototherapy. Temperature monitoring is a routine part of newborn care to assess for signs of infection or other health issues.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is in labour. Which of the following findings should prompt the nurse to reassess the client?

Correct Answer is D

Explanation

A nurse is planning care for a full-term newborn who is receiving phototherapy. Which of the following actions should the nurse include in the plan of care?

Correct Answer is A

Explanation

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