A physician writes the following order: administer ampicillin 1 g IV every 4 hours until delivery for a newly admitted client with ruptured membranes.
The client had positive vaginal and rectal cultures for GBS+ at 36 weeks gestation.
Which of the following is a rationale for this order?
The bacteria cause perineal sepsis.
The client is at risk for chorioamnionitis.
The bacteria are sexually transmitted.
The baby is at high risk for neonatal sepsis.
The Correct Answer is D
Choice A rationale
Group B Streptococcus (GBS) is not typically associated with perineal sepsis; rather, it is a bacterium that colonizes the gastrointestinal and genitourinary tracts.
Choice B rationale
While GBS colonization can pose risks, chorioamnionitis is a different infection involving the membranes and amniotic fluid, often caused by a variety of microorganisms, not solely GBS.
Choice C rationale
GBS is not primarily sexually transmitted; it is a bacterium naturally present in the genital and digestive tracts, and colonization can occur without sexual contact.
Choice D rationale
Neonatal sepsis is a serious risk for babies born to mothers colonized with GBS, necessitating antibiotic prophylaxis to prevent transmission and subsequent infection in the newborn.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale
While iron-rich foods are important, the decrease in hematocrit is primarily due to hemodilution rather than inadequate iron intake. Hemodilution occurs as plasma volume increases more than red cell mass.
Choice B rationale
Hematocrit changes in pregnancy are typically not indicative of a serious problem but a normal physiological adaptation. Hemodilution reduces hematocrit without indicating a pathological condition.
Choice C rationale
During pregnancy, plasma volume increases by approximately 50%, while red cell mass increases by about 30%, leading to hemodilution. This physiological change results in a lower hematocrit value.
Choice D rationale
Although hematocrit decreases due to hemodilution, it does not mean that there is a deficiency in red blood cell production. It reflects the dilution effect of increased plasma volume during pregnancy.
Correct Answer is C
Explanation
Choice A rationale
Uterine contractions (powers) are essential for cervical dilation and fetal descent. They are involuntary smooth muscle contractions regulated by oxytocin and prostaglandins.
Choice B rationale
The fetus (passenger) significantly influences labor progression. Fetal size, position, and presentation affect the ease of passage through the birth canal.
Choice C rationale
Pressure is not considered one of the five Ps affecting labor and birth. The five Ps are powers, passenger, passageway, position, and psychological response.
Choice D rationale
The birth canal (passageway) includes the bony pelvis and soft tissues, which must adapt to allow the fetus to pass through during labor.
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