A new mom delivered her baby 2 months ago.
The baby's father calls into the office to report that his wife is angry.
She is confused and having conversations with herself.
What is the appropriate response that the nurse should make?

Choice A rationale:

Advising the caller to take his wife to the nearest emergency room for evaluation is the appropriate response. The new mom's symptoms, including confusion and auditory hallucinations (conversations with herself), are indicative of a serious mental health condition. These symptoms could be caused by postpartum psychosis, a rare but severe form of postpartum depression. Postpartum psychosis requires immediate medical attention and hospitalization for the safety of both the mother and the baby. It is essential to rule out any potential medical causes and provide appropriate psychiatric evaluation and treatment in an emergency setting.

Choice B rationale:

Bringing the wife to the office for medication is not appropriate in this situation. The symptoms described by the baby's father are severe and require urgent evaluation in an emergency room. Medication management should only be initiated after a comprehensive psychiatric evaluation, which can be conducted in an emergency room setting.

Choice C rationale:

Suggesting outpatient care is not appropriate in this case. The severity of the symptoms, including confusion and hallucinations, indicates the need for immediate evaluation in an emergency setting. Outpatient care is not sufficient for addressing acute psychiatric emergencies.

Choice D rationale:

Recommending behavioral therapy is not appropriate for a situation involving acute confusion and hallucinations. Behavioral therapy is a valuable treatment for various mental health conditions, but it is not the appropriate intervention for acute symptoms like those described in this scenario.

Choice A rationale:

Breastfeeding mothers can receive the live attenuated rubella virus. Rubella vaccination is part of routine postpartum care for non-immune women. Breastfeeding does not interfere with the effectiveness of the rubella vaccine.

Choice B rationale:

Rubella vaccination is indeed teratogenic and can cause congenital rubella syndrome if a woman becomes pregnant within 28 days of vaccination. It is crucial for healthcare providers to educate women about the importance of avoiding pregnancy for this period after receiving the rubella vaccine to prevent potential harm to the fetus.

Choice C rationale:

Rh immune globulin (RhIg) is given to Rh-negative mothers to prevent Rh isoimmunization. It is administered intramuscularly, not intravenously. Intravenous administration of RhIg can lead to adverse reactions and is not considered a safe route for this medication. RhIg does not have any impact on the infant's immune system.

Choice D rationale:

Rh immune globulin does not boost the immune system or enhance the effectiveness of vaccinations. Its primary function is to prevent the development of antibodies in Rh-negative individuals who have been exposed to Rh-positive blood, such as during pregnancy or delivery.