A nurse is providing instruction to a client about diagnostic tests during their first prenatal visit at 12 weeks of gestation.
Which of the following diagnostic tests should the nurse include in the teaching?

Choice A rationale

Herpes simplex virus 2 (HSV-2) can be harmful to a developing fetus and newborn. While primary infection during the first trimester can rarely lead to congenital anomalies, the most significant risk is neonatal herpes, which occurs when the newborn is exposed to the virus during passage through the birth canal if active lesions are present. Neonatal herpes can cause severe, life-threatening complications.

Choice B rationale

Transmission of HSV-2 to the newborn is significantly higher if active genital lesions are present at the time of vaginal birth. The virus can be shed from these lesions and infect the infant as they pass through the birth canal. Therefore, a Cesarean section is typically recommended if active lesions are present at the onset of labor.

Choice C rationale

Wearing tight-fitting undergarments can increase moisture and friction, potentially irritating existing lesions and hindering healing. Loose-fitting cotton undergarments are generally recommended to allow air circulation and reduce irritation, promoting a more favorable environment for lesion resolution and comfort.

Choice D rationale

Antiviral medications, such as acyclovir, valacyclovir, or famciclovir, can help manage genital herpes by reducing the frequency, duration, and severity of outbreaks. They work by inhibiting viral replication. However, these medications do not cure the condition; HSV-2 remains a lifelong viral infection.

Choice A rationale: Ensuring suction is available is critical because clients with severe preeclampsia or eclampsia are at risk for seizures that can cause airway obstruction from secretions or vomiting. Suction readiness supports immediate airway management during a seizure, preventing aspiration and maintaining oxygenation, essential in protecting maternal and fetal health.

Choice B rationale: Administering 10 L of oxygen via nasal cannula is not appropriate because nasal cannulas typically deliver oxygen up to 6 L/min; higher flows require a different delivery system like a non-rebreather mask. Also, routine high-flow oxygen is not indicated unless hypoxia is present. The client’s oxygen saturation is normal (99%), so supplemental oxygen at this rate is unnecessary and could cause discomfort or drying of mucous membranes.

Choice C rationale: Raising side rails is a safety measure to prevent injury during seizures or sudden movements caused by central nervous system irritability in preeclampsia. Elevated side rails help protect the client from falls or trauma if a seizure occurs, an essential precaution in clients with neurological symptoms such as hyperreflexia and clonus.

Choice D rationale: Placing a padded tongue blade at the bedside prepares for seizure management by preventing tongue biting and airway obstruction. The padded blade reduces the risk of oral trauma during convulsions and maintains airway patency. However, it should be used carefully to avoid airway injury or obstruction and only if a seizure occurs.

Choice E rationale: Dimming lights reduces environmental stimuli that may exacerbate neurological irritability or trigger seizures in preeclampsia/eclampsia. Bright or flashing lights can increase CNS excitation, worsening headache, visual disturbances, or seizure risk. Creating a calm, low-stimulation environment helps stabilize the client’s neurological status.

Choice F rationale: Placing the client in the supine position is contraindicated because it compresses the inferior vena cava, reducing venous return and cardiac output, potentially worsening placental perfusion. The left lateral position is preferred in hypertensive pregnancy to optimize uteroplacental blood flow and maternal hemodynamics, improving fetal oxygenation and maternal comfort.