A nurse is planning care for a client who is pregnant and has HIV. Which of the following actions should the nurse include in the plan of care?

Instruct the client to stop taking the antiretroviral medications at 32 weeks of gestation.

Use a fetal scalp electrode during labor and delivery.

Bathe the newborn before initiating skin-to-skin contact.

Administer a pneumococcal immunization to the newborn within 4 hr following

Answer and Explanation

The Correct Answer is C

The purpose of bathing the newborn before initiating skin-to-skin contact is to decrease the risk of transmission of the virus from the mother to the newborn. Instructing the client to stop taking the antiretroviral medications at 32 weeks of gestation is incorrect as these medications should be taken throughout pregnancy to decrease the risk of transmission to the fetus.

Using a fetal scalp electrode during labor and delivery is also not an appropriate action as it increases the risk of transmission of the virus to the newborn. Administering a pneumococcal immunization to the newborn within 4 hours following birth is not specific to HIV positive newborns and is not related to preventing transmission of the virus.

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Correct Answer is A

Explanation

A newborn's urine output is a good indicator of hydration status, and it is important to ensure that the newborn is receiving adequate fluid intake. A newborn typically urinates at least 6-8 times a day, so if the newborn urinates less than six times a day, it could indicate dehydration or another issue that requires medical attention.

The nurse should not instruct the client to place triple antibiotic ointment on the baby's umbilical cord, as this can actually delay the healing process and increase the risk of infection. Instead, the nurse should advise the client to keep the umbilical cord clean and dry, and to contact the healthcare provider if there are any signs of infection (such as redness, swelling, or discharge).

The nurse should also not instruct the client to swaddle the baby tightly with his legs extended before laying him down to sleep, as this can increase the risk of hip dysplasia. Instead, the nurse should advise the client to place the baby on his back to sleep, on a firm and flat surface with no soft bedding, toys, or pillows.

Lastly, the nurse should not instruct the client to retract the foreskin to clean the baby's penis during each bath. In fact, the foreskin should never be forcibly retracted in a newborn, as it can cause pain, bleeding, and increase the risk of infection. The nurse should advise the client to simply clean the penis with warm water and mild soap during bath time, without forcibly retracting the foreskin.

A. "You should use spermicide 3 hours prior to sexual intercourse." B. "You will not need to use birth control for 1 month after receiving emergency contraception." C. "You should have an annual examination to assess your diaphragm." D. "Your fertility will return 6 months after your provider removes your IUD."

Correct Answer is C

Explanation

The nurse should include in the teaching that clients who use a diaphragm for birth control should have an annual examination to assess its fit and effectiveness. The nurse should also educate clients on the proper use and care of the diaphragm.

Spermicide should be used no more than 30 minutes prior to sexual intercourse, not 3 hours prior.

Emergency contraception does not provide ongoing protection against pregnancy, so clients will need to use another form of birth control immediately after taking the medication.

Fertility can return quickly after the removal of an IUD, usually within a few weeks to a month.

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A nurse is planning care for a client who is pregnant and has HIV. Which of the following actions should the nurse include in the plan of care?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

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