Which of the following information should the nurse include when providing teaching to an antepartum client with a new diagnosis of genital herpes simplex virus 2 (HSV-2)?

Choice A reason: Critical congenital heart disease (CCHD) screening uses pulse oximetry, not a heel blood sample. Blood sampling is for metabolic screening, not heart defects. Pulse oximetry measures oxygen saturation non-invasively, detecting shunting or cyanotic defects, aligning with CCHD screening’s focus on circulatory assessment.

Choice B reason: CCHD screening is typically performed at 24-48 hours of age, not 6-12 hours, to ensure stable postnatal circulation. Early testing may yield false positives due to transitional physiology. Pulse oximetry at the correct timing accurately detects critical heart defects, per neonatal screening protocols.

Choice C reason: CCHD screening compares oxygen saturation in the upper (right hand) and lower (foot) extremities using pulse oximetry to detect congenital heart defects causing differential cyanosis. A significant difference indicates potential shunting or ductal-dependent lesions, requiring further evaluation, aligning with the physiological basis of CCHD screening.

Choice D reason: CCHD screening results are immediate via pulse oximetry, not delayed 1-2 weeks. Real-time oxygen saturation readings identify potential heart defects, enabling prompt referral for echocardiography. Delayed results apply to metabolic screening, not CCHD, which relies on instant physiological data, per neonatal diagnostic protocols.

Choice A reason: Obtaining the client’s temperature, heart rate, and blood pressure assesses maternal status but is not the highest priority. Nausea and an urgent need for a bowel movement suggest advanced labor or fetal head compression. Fetal heart rate (FHR) monitoring is critical, as strong contractions may reduce placental perfusion, risking fetal hypoxia, which takes precedence over maternal vital signs to ensure immediate fetal safety.

Choice B reason: Examining vaginal discharge for meconium indicates potential fetal stress but is not the highest priority. Nausea and bowel urgency suggest rapid labor progression or fetal head compression, impacting FHR. Assessing FHR first ensures fetal oxygenation status, as meconium is a secondary finding that does not immediately guide interventions for acute distress during strong contractions.

Choice C reason: Determining the fetal heart rate in relationship to contractions is the highest priority, as nausea and bowel urgency indicate possible second-stage labor or fetal head compression, causing FHR decelerations. Strong contractions may reduce placental blood flow, risking hypoxia. Continuous monitoring via scalp electrode detects late or variable decelerations, guiding urgent interventions to ensure fetal safety.

Choice D reason: Performing a sterile vaginal examination assesses labor progress but is not the highest priority. Nausea and bowel urgency suggest advanced labor, but FHR assessment takes precedence to rule out fetal distress. Vaginal exams risk infection or membrane rupture and do not directly address fetal oxygenation, critical during strong contractions that may compromise placental perfusion.