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 D
Explanation
Choice A rationale:
Levothyroxine is not a medication used to treat gestational diabetes mellitus. Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism, which is a different medical condition.
Choice B rationale:
Nifedipine is a calcium channel blocker primarily used to manage hypertension and angina. It is not indicated for the treatment of gestational diabetes mellitus.
Choice C rationale:
Chlorpromazine is an antipsychotic medication used to treat conditions like schizophrenia and bipolar disorder. It has no role in the treatment of gestational diabetes mellitus.
Choice D rationale:
Glyburide is the correct medication to expect for administering to a client with gestational diabetes mellitus. Glyburide is an oral antidiabetic agent that helps lower blood glucose levels by increasing insulin secretion from the pancreas. It is often used when dietary and lifestyle modifications are not sufficient in managing gestational diabetes. However, it is essential to follow healthcare provider guidelines and closely monitor the client's blood glucose levels while on this medication. In some cases, insulin may be required if glyburide alone is inadequate in controlling blood sugar levels.
Correct Answer is D
Explanation
Choice A rationale:
This statement is incorrect. An indirect Coombs' test is not used to determine the risk of hypoglycemia in a baby after birth. It is used to detect antibodies against red blood cells, particularly in the context of blood incompatibility between a pregnant woman and her fetus.
Choice B rationale:
This statement is incorrect. An indirect Coombs' test is not related to determining the amount of amniotic fluid around the fetus. It is used primarily to assess for Rh incompatibility between the mother and fetus.
Choice C rationale:
This statement is incorrect. The test described here is a Doppler ultrasound, not an indirect Coombs' test. Doppler ultrasound is used to study blood flow in the fetus and placenta using ultrasound waves.
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