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.

Answer and Explanation

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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Correct Answer is B

Explanation

Choice A rationale
Administering a Rhogam injection is not indicated because the patient is Rh-positive (blood type B) and Rhogam is for Rh-negative individuals to prevent sensitization.
Choice B rationale
Teaching about iron-rich foods is appropriate, given her hemoglobin level of 10.5 gm/dL and hematocrit of 32%, indicating mild anemia; iron-rich foods help increase hemoglobin.
Choice C rationale
Starting PO antibiotics for GBS is unnecessary at this stage; antibiotics are administered during labor to prevent neonatal infection, not during prenatal care.
Choice D rationale
Avoiding exposure to rubella is important, but there is no indication in her current prenatal labs that she needs immediate teaching about this infection.

A. Test the fluid with nitrazine paper to confirm membrane rupture. B. Document the time of rupture of membranes. C. Monitor the fetal heart rate and pattern. D. Notify the physician or midwife immediately.

Correct Answer is C

Explanation

Choice A rationale
Testing the fluid with nitrazine paper can confirm membrane rupture but is not the first priority. Assessing the fetal heart rate is crucial to ensure fetal well-being immediately after membrane rupture.
Choice B rationale
Documenting the time of rupture is important for clinical records but is not the first priority. Immediate assessment of fetal status takes precedence to detect any distress.
Choice C rationale
Monitoring the fetal heart rate and pattern immediately after membrane rupture is essential to ensure the fetus is not in distress. It helps detect any complications like cord prolapse.
Choice D rationale
Notifying the physician or midwife is necessary but not the first priority. Ensuring fetal well-being through heart rate monitoring is the immediate concern following membrane rupture.

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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?

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Correct Answer is B

Explanation

A multipara in latent phase of labor experiences spontaneous rupture of membranes while walking. Which is the first priority nursing action?

Correct Answer is C

Explanation

When administering Pitocin, you should start at a low dose and work your way up slowly to a dose that provides the best contraction rate.

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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?