A nurse is providing prenatal care to a pregnant client. At which time would the nurse expect to screen the client for group B streptococcus infection?

Choice A Reason: This is correct because this response provides realistic and supportive advice for a woman who wants to have a baby with lupus. Lupus is an autoimmune disease that causes inflammation and damage to various organs and tissues. Lupus can affect fertility and pregnancy outcomes, such as increasing the risk of miscarriage, preterm delivery, preeclampsia, or neonatal lupus. Therefore, it is important for the woman to have her lupus under control before conceiving and to consult with her doctor about her treatment plan and prenatal care.

Choice B Reason: This is incorrect because this response is discouraging and insensitive for the woman who wants to have a baby with lupus. Lupus does not necessarily prevent a woman from having a healthy pregnancy and a healthy baby, as long as she follows her doctor's recommendations and monitors her condition closely. The nurse should respect the woman's reproductive choices and provide information and support.

Choice C Reason: This is incorrect because this response is inaccurate and misleading for the woman who wants to have a baby with lupus. Lupus can have various effects on pregnancy, such as causing flares or complications that can affect both the mother and the baby. The nurse should educate the woman about the possible risks and benefits of pregnancy with lupus and help her prepare for any challenges.

Choice D Reason: This is incorrect because this response is vague and alarming for the woman who wants to have a baby with lupus. Lupus treatment may or may not change during pregnancy, depending on the type and severity of lupus, the medications used, and the stage of pregnancy. The nurse should explain the rationale and safety of any medication changes and address any concerns or questions that the woman may have.

Choice A Reason: This is incorrect because gastrointestinal bleeding is not an adverse effect of hydralazine, which is a vasodilator that lowers blood pressure by relaxing the smooth muscles of the blood vessels. Gastrointestinal bleeding can be caused by other conditions such as ulcers, gastritis, or hemorrhoids.

Choice B Reason: This is incorrect because sweating is not an adverse effect of hydralazine, but a normal response to vasodilation and heat loss. Sweating can also be caused by other factors such as fever, anxiety, or exercise.

Choice C Reason: This is correct because tachycardia is an adverse effect of hydralazine, which can occur as a reflex response to vasodilation and hypotension. Tachycardia can increase the cardiac workload and oxygen demand, which can be harmful for pregnant women with preeclampsia who already have impaired placental perfusion and fetal hypoxia.

Choice D Reason: This is incorrect because blurred vision is not an adverse effect of hydralazine, but a symptom of severe preeclampsia that indicates cerebral edema or ischemia. Blurred vision can also be caused by other conditions such as diabetes, glaucoma, or cataracts.