The nurse is caring for a woman who is at 24 weeks of gestation with suspected severe preeclampsia. Which signs and symptoms would the nurse expect to observe? (Select all that apply)

Choice A reason: Penicillin is not a correct option, as it is not effective against chlamydia. Penicillin is an antibiotic that works by inhibiting the cell wall synthesis of bacteria. However, chlamydia is an intracellular bacterium that does not have a cell wall and is resistant to penicillin.

Choice B reason: Acyclovir is not a correct option, as it is not effective against chlamydia. Acyclovir is an antiviral drug that works by inhibiting the DNA synthesis of viruses. However, chlamydia is a bacterium, not a virus, and is not affected by acyclovir².

Choice C reason: Doxycycline is the correct option, as it is one of the recommended medications for the treatment of chlamydia. Doxycycline is a tetracycline antibiotic that works by inhibiting the protein synthesis of bacteria. It can penetrate the cells and kill chlamydia by interfering with its growth and reproduction. The CDC recommends a 7-day course of doxycycline (100 mg orally twice a day) for the treatment of uncomplicated chlamydia infection.

Choice D reason: Podofilox is not a correct option, as it is not effective against chlamydia. Podofilox is a topical medication that works by destroying the tissue of genital warts caused by human papillomavirus (HPV). However, chlamydia is a different infection that does not cause genital warts and is not treated by podofilox.

Choice A reason: Women without pain and who do not want to become pregnant need no treatment, as endometriosis is a benign condition that does not affect the general health or well-being of the woman. The nurse should explain to the client that endometriosis is a chronic condition that causes the growth of endometrial tissue outside the uterus, and that it can cause symptoms such as pelvic pain, dysmenorrhea, dyspareunia, and infertility. However, if the woman is asymptomatic and has no desire for pregnancy, she can choose to monitor the condition without any intervention.

Choice B reason: Surgical intervention often is needed for severe or acute symptoms, as endometriosis can cause complications such as adhesions, cysts, inflammation, or obstruction of the pelvic organs. The nurse should inform the client that surgery can be performed to remove or destroy the endometrial implants, or to perform a hysterectomy or oophorectomy in severe cases. The nurse should also discuss the benefits and risks of surgery, and the possibility of recurrence or persistence of symptoms.

Choice C reason: Side effects from the steroid danazol include masculinizing traits, as danazol is a synthetic androgen that suppresses the ovarian function and reduces the production of estrogen and progesterone. The nurse should warn the client that danazol can cause adverse effects such as acne, hirsutism, weight gain, voice changes, decreased breast size, and menstrual irregularities. The nurse should also advise the client to use a non-hormonal contraceptive method while taking danazol, as it can harm the fetus if pregnancy occurs.

Choice D reason: Bone loss from hypoestrogenism is not irreversible, as it can be prevented or treated with calcium and vitamin D supplements, bisphosphonates, or hormone replacement therapy. The nurse should educate the client that hypoestrogenism is a condition where the estrogen levels are abnormally low, and that it can occur as a result of some medications or surgical procedures for endometriosis. The nurse should also explain that hypoestrogenism can increase the risk of osteoporosis, which is a condition where the bones become weak and brittle.

Choice E reason: Women with mild pain who may want a future pregnancy may take nonsteroidal anti-inflammatory drugs (NSAIDs), as NSAIDs can reduce the inflammation and pain caused by endometriosis. The nurse should recommend the client to take NSAIDs as needed, and to follow the dosage and instructions on the label. The nurse should also inform the client that NSAIDs are not effective in treating the underlying cause of endometriosis, and that they may have side effects such as gastrointestinal irritation, bleeding, or ulcers.