Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client’s progress.

A) Rubella titer nonimmune: A nonimmune rubella titer indicates that the client is not immune to rubella, which is a common finding in many pregnant women. However, rubella vaccination is not given during pregnancy because the vaccine is a live virus. The client will typically be vaccinated postpartum. Follow-up would be required, but it is not an urgent concern during the pregnancy itself.

B) Negative varicella titer: A negative varicella titer means the client is not immune to chickenpox, which is a concern because varicella can cause serious complications during pregnancy. However, similar to rubella, the varicella vaccine is contraindicated during pregnancy, and vaccination would be given postpartum. This requires follow-up after delivery but does not require urgent intervention during the pregnancy.

C) Positive Rh factor: The Rh factor is a blood type characteristic, but what is typically more concerning is the Rh incompatibility, which occurs when a Rh-negative mother carries a Rh-positive baby. A positive Rh factor is not a problem for the client themselves but could be important if the father is Rh-positive. If there is concern for Rh incompatibility, the nurse would monitor for the development of Rh sensitization and administer Rh immunoglobulin (RhoGAM) if needed. This does not require urgent intervention unless Rh incompatibility is confirmed.

D) Positive serologic test for syphilis: A positive test for syphilis requires immediate follow-up intervention. Syphilis is a sexually transmitted infection that can cause serious complications during pregnancy, including miscarriage, stillbirth, preterm birth, and congenital syphilis. Treatment with penicillin is recommended to prevent transmission to the baby and to treat the infection in the mother. A positive serologic test for syphilis warrants prompt intervention.

A) "Put small cushion under the newborn's head for support.":
This statement is incorrect. Placing a small cushion or any additional padding under a newborn’s head in a car seat is not recommended. Extra padding can interfere with the proper fit of the harness and could pose a safety risk in the event of a crash. The car seat should be used as designed, without extra padding that could affect the infant's positioning.

B) "Position the car seat at a 90° angle.":
This statement is incorrect. The car seat should be positioned at a 45-degree angle, not 90 degrees. A 45-degree angle helps prevent the infant’s head from falling forward, which can obstruct the airway and cause breathing difficulties. Positioning the seat at the correct angle ensures that the baby’s head and neck are properly supported.

C) "Place the shoulder harnesses at the level of the infant's shoulders.":
This statement is correct. For optimal safety, the shoulder harness straps should be at or just below the infant's shoulders when they are in a rear-facing car seat. This positioning helps to keep the baby secure and ensures the harness fits properly in the event of an accident. The harness should be snug and positioned correctly to provide the best protection.

D) "Keep the airbag on if the car seat is in the front seat.":
This statement is incorrect. It is recommended that infants and young children always be placed in a rear-facing car seat in the back seat of the vehicle, as this is the safest position. Airbags can be dangerous to infants if the car seat is in the front seat. If the car seat must be placed in the front seat (which is not recommended), the airbag should be turned off to prevent injury in the event of a crash.