A nurse is assessing the lifestyle practices of a pregnant client.
Which of the following lifestyle factors indicates an increased risk for high-risk pregnancy?

Choice A rationale

Immediately bathing a newborn with herpes simplex virus is generally discouraged. While it might seem intuitive for infection control, vigorous bathing could theoretically disrupt skin integrity and potentially spread the virus to other areas of the body or mucous membranes, exacerbating the infection.

Choice B rationale

Initiating contact precautions is essential for a newborn with herpes simplex virus. This highly contagious viral infection requires strict measures to prevent transmission to other vulnerable neonates and healthcare providers. Contact precautions involve gown and glove use, limiting direct contact with the newborn or contaminated surfaces.

Choice C rationale

Administering ampicillin IV is not the appropriate treatment for herpes simplex virus. Ampicillin is an antibiotic effective against bacterial infections, not viral infections like herpes simplex. Antiviral medications, such as acyclovir, are the specific treatment for neonatal herpes simplex virus to inhibit viral replication.

Choice D rationale

Withholding breastfeeding is not typically indicated for a newborn with in utero transmitted herpes simplex virus unless the mother has active lesions on her breasts. The primary concern is direct skin-to-skin transmission if lesions are present. Breast milk itself provides beneficial antibodies and is not a route of transmission for in utero infection.

Choice A rationale

Palpating contractions as mild indicates that the current oxytocin dose is likely insufficient to achieve an expected labor pattern. Oxytocin aims to induce moderate-to-strong uterine contractions, typically occurring every 2-3 minutes, lasting 40-90 seconds. Mild contractions suggest suboptimal uterine activity, justifying an increase in the infusion rate to stimulate more effective contractions.

Choice B rationale

Spontaneous rupture of membranes is a natural progression of labor and does not directly indicate the need to titrate oxytocin based on uterine contraction effectiveness. While rupture of membranes can accelerate labor, the oxytocin titration decisions are primarily based on the intensity and frequency of uterine contractions, not the status of the amniotic sac.

Choice C rationale

A decrease in the client's pain level is not an indicator for titrating oxytocin for labor induction. Pain is subjective and influenced by various factors, including analgesia. Oxytocin titration is guided by objective measures of uterine activity and cervical change, aiming for an adequate labor pattern rather than pain management.

Choice D rationale

Stabilization of the client's blood pressure, while desirable, is not a direct parameter for titrating oxytocin to achieve an expected labor pattern. Oxytocin's primary effect is on uterine contractility, and titration decisions are based on the frequency, duration, and intensity of contractions, and cervical dilation, not systemic blood pressure changes.