Which of the following information should the nurse include when teaching a group of students about effective use of the vaginal contraceptive ring?

Choice A reason: Immediately bathing a newborn with herpes simplex virus (HSV) is not recommended, as it may spread lesions or increase infection risk. HSV, a viral infection, requires antiviral therapy, not bathing, to manage cutaneous lesions. Bathing could disrupt skin integrity, potentially exacerbating viral spread or secondary bacterial infections in a compromised neonate.

Choice B reason: Administering ampicillin, a bacterial antibiotic, is ineffective against HSV, a viral infection. Neonatal HSV requires antiviral drugs like acyclovir to target viral replication. Ampicillin addresses bacterial infections, such as group B streptococcus, but lacks efficacy against herpesviruses, making it an inappropriate treatment choice for this condition based on microbiological principles.

Choice C reason: Withholding breastfeeding is unnecessary unless active HSV lesions are present on the breast. HSV transmission via breast milk is rare, and breastfeeding supports neonatal immunity. If the mother has no active lesions, breastfeeding is safe with proper hygiene, as the virus primarily spreads through direct contact with lesions, not milk.

Choice D reason: Initiating contact precautions is critical for neonatal HSV, as the virus spreads through direct contact with lesions or secretions. Precautions, including gloves and gowns, prevent transmission to healthcare workers and other patients. HSV’s high infectivity in neonates, due to immature immunity, necessitates strict isolation to control viral spread in clinical settings.

Choice A reason: Bladder distention indicates an adverse effect of epidural analgesia, as nerve blockade impairs bladder sensation, leading to retention. This is not a sign of effective pain relief but a complication requiring monitoring or catheterization to prevent urinary tract infections or bladder overdistension, per epidural side effect management.

Choice B reason: Reporting slight pressure with contractions indicates effective epidural analgesia, as it reduces pain while preserving some sensation, allowing awareness of labor progress. This reflects targeted nerve blockade, alleviating visceral pain via opioid and anesthetic action, aligning with the goal of balanced labor analgesia without complete sensory loss.

Choice C reason: Inability to move legs or feet suggests excessive epidural blockade, a complication rather than effective analgesia. Optimal epidurals provide pain relief with minimal motor impairment, allowing mobility. Complete paralysis risks prolonged recovery or injury, not reflecting the therapeutic goal of labor pain management, per anesthesia protocols.

Choice D reason: A 20 mm Hg systolic blood pressure decrease indicates hypotension, an adverse effect of epidural analgesia due to sympathetic blockade. This risks reduced placental perfusion, not effective pain relief. It requires intervention like fluids, contrary to the goal of stable analgesia with minimal maternal or fetal impact.