The nurse is caring for a laboring client who is group B Streptococcus positive (GBS+). Which immediate treatment is indicated for this client?

Artificial rupture of the membranes.

Administration of antibiotics.

Amnioinfusion for the baby.

Administration of oxytocin.

Answer and Explanation

The Correct Answer is B

A. Artificial rupture of the membranes: While artificial rupture of membranes may be done in some situations, it is not an immediate treatment for a GBS-positive client. The priority is to reduce the risk of infection, which is best achieved with antibiotics.
B. Administration of antibiotics: The most important and immediate treatment for a GBS-positive laboring client is administration of antibiotics, usually penicillin or ampicillin, to reduce the risk of transmitting the infection to the baby during delivery. This is typically given during labor.
C. Amnioinfusion for the baby: Amnioinfusion is a procedure used to relieve umbilical cord compression or meconium aspiration, but it is not indicated for managing GBS infection. Antibiotics are the primary treatment to prevent neonatal infection.
D. Administration of oxytocin: Oxytocin is used to stimulate labor but is not the immediate priority for a GBS-positive client. The focus should be on preventing infection through antibiotic administration, not on initiating or enhancing labor.

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Correct Answer is A

Explanation

A. One-hour glucose screen: The one-hour glucose screen is typically performed at 24-28 weeks gestation to screen for gestational diabetes. This is a standard test for all pregnant women during this time frame, regardless of ethnicity, and should be included in the client teaching.
B. Repeat HIV test: While HIV screening is important during pregnancy, a repeat HIV test at 28 weeks is not typically recommended for all women unless they are at high risk or have specific risk factors.
C. Multiple marker screening: This screening is usually done earlier in pregnancy, typically between 15-20 weeks, to assess the risk of certain fetal conditions like Down syndrome and neural tube defects. It is not performed at 28 weeks.
D. Direct Coombs' test: The Direct Coombs' test is typically performed on newborns, not on pregnant women, to check for hemolytic disease. However, Rh-negative women are often screened with the indirect Coombs' test at 28 weeks to check for antibodies, not the direct Coombs' test.

A. Inspect the perineal pad. B. Encourage voiding. C. Monitor vital signs. D. Notify healthcare provider.

Correct Answer is B

Explanation

A. Inspect the perineal pad: While it is important to assess for bleeding, the primary concern in this scenario is the displaced and boggy uterus, which suggests the need to address potential bladder distention.

B. Encourage voiding: A boggy, displaced uterus, particularly if it is to the right and above the umbilicus, is often a sign of bladder distention. Encouraging the client to void will help relieve bladder pressure on the uterus, allowing it to contract properly and reduce the risk of hemorrhage.

C. Monitor vital signs: Vital signs should always be monitored, but addressing the underlying cause of the boggy and displaced uterus (bladder distention) is a more immediate priority to prevent complications such as postpartum hemorrhage.

D. Notify healthcare provider: While notifying the healthcare provider is important if the problem persists, the nurse should first address bladder distention by encouraging the client to void. This may resolve the issue without the need for further intervention.

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The nurse is caring for a laboring client who is group B Streptococcus positive (GBS+). Which immediate treatment is indicated for this client?

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Naxlex Comprehensive Predictor Exams

The nurse is providing anticipatory guidance for an African-American client who is at 24-weeks gestation. Which prenatal laboratory assessment, prescribed at 28-weeks, should the nurse include in client teaching?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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