The healthcare provider prescribes oxytocin 10 units/L IV infusion to augment a client's labor because she is experiencing a prolonged active phase.

Which finding would cause the nurse to immediately discontinue the oxytocin?

Choice A rationale

Zidovudine is a nucleoside reverse transcriptase inhibitor (NRTI). It works by inhibiting the enzyme reverse transcriptase, which is crucial for the replication of retroviruses like HIV. It does not possess any antifungal properties. Fungal infections, such as candidiasis, are often treated with antifungal agents like fluconazole, not antiretroviral drugs.

Choice B rationale

Chorioamnionitis is an intrauterine infection of the chorion and amnion, typically caused by ascending bacteria. It is treated with broad-spectrum antibiotics to address the bacterial etiology. Zidovudine is an antiviral medication specifically targeting the replication of HIV and is ineffective against bacterial infections.

Choice C rationale

Zidovudine works by inhibiting reverse transcriptase, thereby preventing the viral RNA of HIV from being converted into DNA. This mechanism significantly reduces the viral load in the mother and the risk of transplacental transmission to the fetus. This strategy is a cornerstone of preventing perinatal HIV transmission.

Choice D rationale

While zidovudine is a component of highly active antiretroviral therapy (HAART) for managing HIV infection in adults, its primary purpose in the context of labor and delivery is to prevent vertical transmission to the newborn. The treatment regimen for the mother's own HIV complications is a separate, long-term protocol.

Choice A rationale

While obtaining a smoking history is a crucial component of an adolescent's health assessment, it is not the most important initial intervention. Building rapport and creating a confidential environment are foundational for encouraging open communication. By prioritizing sensitive questions like smoking history first, the nurse may risk alienating the adolescent and hindering the overall health history process.

Choice B rationale

Adolescents often feel more comfortable and are more likely to disclose sensitive information, such as substance use, sexual activity, or mental health concerns, when their parents are not present. This provides a confidential and private setting that respects their autonomy and encourages them to speak openly and honestly, which is essential for a comprehensive and accurate health history.

Choice C rationale

Assessing for the use of illicit drugs is a critical part of a comprehensive health history for an adolescent. However, it is a specific component of the interview that should occur after a foundation of trust and confidentiality has been established. This question, if asked prematurely, may cause the adolescent to become defensive or reluctant to share other important health information.

Choice D rationale

Evaluating vital signs and lab findings is an important part of any health assessment. However, it is a physical or objective data collection step, not an intervention for obtaining a health history. The most important initial intervention when conducting a health history with an adolescent is to establish an environment of trust and confidentiality, which is a prerequisite for gathering subjective data.