A nurse is caring for a newborn who has herpes simplex virus as a result of in utero transmission.
Which of the following actions should the nurse take?
Immediately bathe the newborn.
Initiate contact precautions.
Administer ampicillin IV.
Withhold breastfeeding.
The Correct Answer is B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Step 1 is to determine the number of days from April 1 to December 26. Days in April = 30 - 1 + 1 = 30 days. Days in May = 31 days. Days in June = 30 days. Days in July = 31 days. Days in August = 31 days. Days in September = 30 days. Days in October = 31 days. Days in November = 30 days. Days in December = 26 days. Total number of days = 30 + 31 + 30 + 31 + 31 + 30 + 31 + 30 + 26 = 270 days.
Step 2 is to convert the total number of days into weeks. 270 days ÷ 7 days/week = 38.57 weeks.
Step 3 is to round to the nearest whole week. The anticipated gestational age is 39 weeks.
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
Vacuum-assisted delivery increases the risk of postpartum hemorrhage due to potential trauma to the birth canal and uterine atony caused by prolonged pressure or rapid extraction. The vacuum device can bruise the cervix, vagina, or perineum, leading to lacerations that bleed excessively. It can also overstretch uterine muscles, impairing their ability to contract effectively after birth.
Choice B rationale
A newborn weight of 2.948 kg (6 lb 8 oz) is within the normal weight range for a full-term infant. This weight does not typically pose an increased risk for postpartum hemorrhage. Larger infants (macrosomia, generally > 4 kg) are associated with higher risks due to increased uterine stretching and potential for prolonged labor or birth trauma.
Choice C rationale
Labor induction with oxytocin significantly increases the risk for postpartum hemorrhage, particularly due to uterine atony. Prolonged oxytocin administration can lead to desensitization of myometrial receptors, reducing the uterus's ability to contract effectively postpartum. This impaired contractility prevents compression of uterine blood vessels, resulting in excessive bleeding.
Choice D rationale
A history of uterine atony is a substantial risk factor for recurrent postpartum hemorrhage. Uterine atony is the most common cause of postpartum hemorrhage, accounting for a majority of cases. A prior history indicates a predisposition for the uterine musculature to fail in contracting adequately after birth, leading to uncontrolled blood loss.
Choice E rationale
A history of human papillomavirus (HPV) infection does not directly increase the risk of postpartum hemorrhage. HPV is a viral infection that primarily affects epithelial cells, often leading to genital warts or cervical dysplasia. It does not inherently alter uterine contractility, coagulation factors, or predispose to abnormal placental implantation, which are direct causes of hemorrhage.
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