A client at 38-weeks gestation presents to the labor and delivery (L&D) unit in active labor. Based on which assessment finding should the nurse notify the surgery team to prepare for a primary cesarean section?

Treated 10 days ago for chlamydia.

Active herpes lesions on the perineum.

Positive western blot for HIV virus.

Group B Streptococcus positive.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Chlamydia trachomatis is a sexually transmitted infection that can cause neonatal conjunctivitis and pneumonia if the newborn is exposed during vaginal delivery. However, if the infection was treated at least 7 days prior to delivery, the risk of transmission is significantly reduced, and a cesarean section is not indicated for this reason.

Choice B rationale

Active herpes simplex virus (HSV) lesions on the perineum present a significant risk of transmitting the virus to the neonate during vaginal delivery. Neonatal herpes is a serious, often fatal, condition. Therefore, a primary cesarean section is performed to prevent the newborn from coming into contact with the lesions.

Choice C rationale

A positive Western blot for HIV indicates the presence of the virus. A cesarean section is sometimes recommended to reduce the risk of perinatal HIV transmission, but a vaginal birth is not an absolute contraindication, especially if the client has a low viral load from effective antiretroviral therapy.

Choice D rationale

Group B Streptococcus (GBS) is a common bacterium that can colonize the vagina and rectum. It can cause serious infections in newborns. However, the standard of care is to administer intrapartum antibiotic prophylaxis to the mother, not to perform a cesarean section, to prevent transmission.

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Correct Answer is ["A","B","C"]

Explanation

Estimated blood loss of 750 mL at delivery
- Although below the 1,000 mL threshold for major PPH, this amount is still significant for a vaginal delivery and may contribute to anemia and ongoing bleeding symptoms.
Labor lasted 50 hours with vacuum-assisted delivery
- Prolonged labor and instrumental delivery are known risk factors for uterine atony and trauma, both of which can lead to PPH2.
Second-degree perineal laceration and left lateral sulcus laceration
- These injuries can contribute to bleeding, especially if not adequately repaired or if bleeding persists from the site.

A. Begin introducing solid foods into the child's diet after the child reaches one year of age. B. Introduce fruits and vegetables simultaneously into the diet. C. Foods are best introduced by mixing them with formula and feeding them to the infant with a feeder bottle. D. Foods should be introduced into a child's diet one at a time, at 4 to 7 day intervals.

Correct Answer is D

Explanation

Choice A rationale

Introducing solid foods at one year of age is too late and may hinder the infant's nutritional development. The American Academy of Pediatrics recommends starting between 4 to 6 months of age when the infant displays readiness cues like head control and interest in food. Waiting too long can lead to nutrient deficiencies, particularly iron, as maternal stores begin to deplete.

Choice B rationale

Introducing new foods one at a time is crucial for identifying potential food allergies or sensitivities. Simultaneous introduction of fruits and vegetables would make it difficult to pinpoint the specific food causing an allergic reaction. This staggered approach, over several days, allows the immune system to acclimate to each new food.

Choice C rationale

Feeding solids from a bottle can lead to overfeeding, as the infant may not be able to regulate intake appropriately. It also bypasses the critical developmental stage of learning to swallow thicker textures and use a spoon. The infant needs to develop oral motor skills and coordination for successful and safe solid food consumption.

Choice D rationale

Introducing new foods one at a time, with a waiting period of 4 to 7 days, is the recommended practice. This method allows the caregiver to easily identify any adverse reactions, such as a rash, diarrhea, or vomiting, associated with a specific food. It's a key strategy for the early detection and management of food allergies.

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A client at 38-weeks gestation presents to the labor and delivery (L&D) unit in active labor. Based on which assessment finding should the nurse notify the surgery team to prepare for a primary cesarean section?

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","C"]

Explanation

Which nutritional information should the nurse plan to provide the mother of a 6-month-old regarding introduction of solid foods?

Correct Answer is D

Explanation

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