A patient with a history of mitral valve prolapse is admitted at 41 weeks gestation for induction of labor.The doctor prescribes intravenous antibiotic therapy for the patient to be given during labor.Based on this information, what is the primary reason for administering antibiotics to this patient at this time?
The patient has heart disease, and the antibiotics will decrease the risk to her fetus of developing endocarditis.
The patient has heart disease, and the antibiotics will decrease her risk of developing pericarditis.
The patient will deliver post-term, and the antibiotics will help to decrease her risk of developing chorioamnionitis.
The patient will deliver post-term, and the antibiotics will decrease the risk to her fetus of developing a systemic infection.
The Correct Answer is A
The correct answer is choice A. The patient has heart disease, and the antibiotics will decrease the risk to her fetus of developing endocarditis. Endocarditis is an infection of the inner lining of the heart and valves, which can be caused by bacteria entering the bloodstream during labor and delivery. Patients with mitral valve prolapse (MVP) are more prone to develop endocarditis because their valve leaflets are floppy and do not close tightly, creating a site for bacterial attachment.Antibiotics can help prevent this complication by killing the bacteria before they reach the heart.
Choice B is wrong because pericarditis is an inflammation of the outer layer of the heart, not the inner lining or valves. It is not related to MVP or bacterial infection.
Choice C is wrong because chorioamnionitis is an infection of the membranes and fluid that surround the fetus, not the heart. It is usually caused by bacteria ascending from the vagina or cervix, not from the bloodstream.
Choice D is wrong because delivering post-term does not increase the risk of systemic infection for the fetus. Systemic infection means infection that affects multiple organs or systems in the body, not just one specific site.
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Correct Answer is B
Explanation
Massaging the uterus helps it contract and prevent excessive bleeding after delivery.Uterine atony is a condition where the uterus does not contract enough to clamp the blood vessels that supply the placenta, leading to postpartum hemorrhage.Uterine massage is one of the interventions to treat uterine atony and restore uterine tone.
Choice A is wrong because having the client void frequently does not directly affect the uterine contraction.However, a full bladder can interfere with uterine contraction and cause displacement of the uterus, so it is important to monitor the bladder status and empty it as needed.
Choice C is wrong because having the client in a side-lying position for comfort does not help with uterine contraction.However, this position may be beneficial for other reasons, such as reducing edema and pain in the perineal area.
Choice D is wrong because keeping the patient on strict bed rest for 24 hours to avoid stress on the uterus does not help with uterine contraction.In fact, early ambulation after delivery can help prevent thromboembolic complications and promote recovery.
Normal ranges for postpartum blood loss are less than 500 mL for vaginal delivery and less than 1000 mL for cesarean delivery.Postpartum hemorrhage is defined as blood loss greater than or equal to 1000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after birth.
Correct Answer is D
Explanation
The correct answer is choice D. Cesarean delivery.A pregnant patient with genital herpes is at higher risk of transmitting the infection to the baby during vaginal delivery, especially if there is an active outbreak near the time of birth.This can cause serious complications for the baby, such as brain damage, eye problems, or even death.Therefore, a cesarean delivery is recommended to avoid contact between the baby and the genital lesions.
Choice A is wrong because forceps-assisted second stage of labor is not a complication of genital herpes.
It is a method of assisted delivery that may be used for various reasons, such as fetal distress, maternal exhaustion, or abnormal presentation.
Choice B is wrong because precipitous delivery, which means a very fast labor and delivery, is not a complication of genital herpes.
It may be caused by factors such as multiparity, strong contractions, or previous rapid deliveries.
Choice C is wrong because prolonged first phase of labor, which means a slow dilation of the cervix, is not a complication of genital herpes.
It may be caused by factors such as ineffective contractions, large fetal size, or malposition.
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