A nurse is caring for a client in the second prenatal visit, the laboratory findings indicate a negative rubella titer. Which of the following is the correct interpretation of this data?
The client is immune to the rubella virus.
Administer the first dose of rubella vaccine at this time.
The client is not experiencing a rubella infection at this time
The client requires a rubella immunization in post-partum
The Correct Answer is D
a. A negative rubella titer indicates that the client is not immune to rubella.
b. Rubella vaccine is contraindicated during pregnancy.
c. A negative rubella titer does not indicate whether the client is currently experiencing a rubella infection.
d. A negative rubella titer means that the client does not have antibodies against the rubella virus, which can cause congenital defects in the fetus if the mother gets infected during pregnancy. Therefore, the client should receive the rubella vaccine after delivery, when it is safe to do so.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
a. Maternal hypotension is not a common side effect of terbutaline, which is a beta-adrenergic agonist that can cause tachycardia and hypertension.
b. Pulmonary edema is a serious complication of terbutaline therapy, which can cause fluid overload, dyspnea, chest pain, and crackles in the lungs. The nurse should monitor the woman's vital signs, oxygen saturation, urine output, and lung sounds, and report any signs of pulmonary edema to the physician immediately.
c. Fetal bradycardia is not related to terbutaline, which can cause fetal tachycardia.
d. Fetal hypokalemia is also not associated with terbutaline, which can cause maternal hypokalemia due to increased potassium uptake by the cells.
Correct Answer is C
Explanation
a. The client should also be placed in Trendelenburg or knee-chest position to reduce cord compression.
b. This is not the first action to take when the umbilical cord is prolapsed.
c. This is a medical emergency that requires immediate intervention to prevent fetal hypoxia and death. The nurse should insert a gloved hand into the vagina and apply upward pressure on the presenting part to lift it off the cord until delivery.
d. This may be necessary if the cord compression cannot be relieved, but the first priority is to relieve the cord compression.
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