Module 9 Postpartum Complications Part I and Communicable Diseases

which of the following congenital infections is associated with spontaneous abortion, preterm birth, and fetal death? 1. toxoplasmosis 2. listeriosis 3. zika virus 4. chickenpox

2. listeriosis toxoplasmosis causes IUGR and low birth weight, chorioretinitis, anemia. zika virus causes microcephaly

Thromboembolic conditions that are of concern during the postpartum period include: (Select all that apply.) 1. amniotic fluid embolism 2. superficial venous thromboembolism 3. DVT 4. PE 5. DIC

2. superficial venous thromboembolism 3. DVT 4. PE

A client who is positive for human immunodeficiency virus (HIV) delivers a newborn infant. The nurse provides instructions to help the client with care of her infant. Which client statement indicates the need for further instruction? 1."I will be sure to wash my hands before and after bathroom use." 2."I need to breast-feed, especially for the first 6 weeks postpartum." 3."Support groups are available to assist me with understanding my diagnosis of HIV." 4."My newborn infant should be on antiviral medications for the first 6 weeks after delivery."

2."I need to breast-feed, especially for the first 6 weeks postpartum." HIV = no breastfeeding

A pregnant woman who is infected with the human immunodeficiency virus (HIV) delivers a newborn infant, and the nurse provides instructions to help the mother regarding care of the infant. Which statements by the client indicate the need for further instruction? Select all that apply. 1."I will be sure to wash my hands thoroughly and frequently." 2."I need to breast-feed, especially for the first 6 weeks postpartum." 3."My baby needs to receive all of the recommended vaccines at the regular schedule." 4."My baby has no symptoms so it is not likely that he has gotten the infection from me." 5."My newborn infant should be on antiviral medications for the first 6 weeks after delivery."

2."I need to breast-feed, especially for the first 6 weeks postpartum." 4."My baby has no symptoms so it is not likely that he has gotten the infection from me."

Coxsackie virus signs and symptoms in the neonate

poor feeding, vomiting, diarrhea, fever, cardiac enlargement, arrhythmias, CHF, pneumonia, mimics bacterial sepsis. Cock = Cardiac issues (arryhtmias, enlargement, CHF) Sack = airplane sack to vomit in (think GI issues)

what is the leading cause of maternal death worldwide?

postpartum hemorrhage

nursing care for varicella (chickenpox)

precautions provide skin care (oatmeal baths) keep child cool (may help with itchiness) apply pressure to itchy area rather than scratching it avoid use of aspirin -- risk for reyes syndrome

Scarlatiniform rash

prickly red rash that's tarts on chest or back and spreads throughout trunk to arms and legs

what are the risk factors for uterine atony?

prolonged labor prolonged oxytocin use precipitous labor uterine distension (multiple gestation, polyhydramnios, macrosomia) fibroid uterus chorioamnionitis use of magSO4 (mag sulfate relaxes smooth muscle AKA uterus) BMI >40 retained placenta

How does erythema infectiosum spread?

respiratory secretions or blood

whats the treatment for west nile virus?

rest, hydration, analgesics, ribavirin, & intravenous immunoglobulin IVIG.

Koplik spots are a diagnostic indicator of

rubeola

how is mumps spread?

saliva and/or respiratory tract secretions

What are the fetal effects of toxoplasmosis?

severity varies with gestational age and congenital infection. Can lead to spontaneous abortion, low birth weight, hepatosplenomegaly, icterous, anemia, chorioretinitis, and/or neurological disease

_______________ is the reactivation infection of latent VZV infection

shingles

What can Varicella zoster virus cause later in life?

shingles Contracting the disease offers lasting natural immunity but because it is latent, it causes herpes zoster (shingles) when reactivated later in life.

what are koplik spots?

small, irregular, bright-red spots with a blue-white center point that appear on the oral membranes

what kind of precautions would be used for varicella (chickenpox)?

standard, airborne, and contact precautions until ALL lesions are CRUSTED

what medications may be used for supportive care for mumps?

steroids and NSAIDS to help with swelling

what is the most common cause of secondary postpartum hemorrhage?

subinvolution

what are the four causes of postpartum hemorrhage?

subinvolution of uterus or uterine atony lacerations of genital tract pelvic hematoma inversion of uterus "SLIP"

what medications are used for toxoplasmosis? when are they given

sulfadiazine or pyrimethamine can be given to mom after first trimester. Mom cannot take if shes allergic to sulfa drugs

How is parvovirus transmitted?

transplacental

How is congenital syphilis transmitted from mom to baby?

transplacental and can be anytime during pregnancy or at birth.

How is cytomegalovirus transmitted?

transplacental and contact with droplets

When is mastitis most likely to occur?

usually in the first 2 - 4 weeks postpartum

whats the rash stage of rubeola (measles)? when does it appear, how does it spread throughout the body

usually on 3rd or 4th day; maculopapular and 1st appears behind the ears and on the forehead then it spreads

what is the principle cause of postpartum hemorrhage?

uterine atony

why does subinvolution of uterus or uterine atony cause postpartum hemorrhage?

uterus cannot contract to stop hemorrhage

what kind of virus causes varicella (chickenpox)?

varicella zoster virus (herpes family)

How is Rubeola (Measles) transmitted?

virus thats spread by direct contact w/ droplets

whats the tx for rubeola (measles)?

vitamin A, antipyretics, and bedrest airborne precautions

what is rubella (german measles)

•Acute disease of childhood that occurs either postnatally or congenitally

when do we screen pregnant moms for zika virus?

•Only recommended for women living in or traveling to Zika endemic areas

what are the clinical manifestations of varicella (chickenpox)?

•Rash normally starts on extremities and spreads to back, torso and face •crops of INTENSELY pruritic lesions that start as spots and develop into "teardrop vesicles" that tend to crust over •After a few days all forms can be seen together, which is indicative of VZV

What are communicable diseases?

Diseases that can be spread from person to person or between animals and people. they are all viral except strep throat

why would I&O catheterization be ordered for a patient with postpartum hemorrhage?

in order to empty bladder and allow uterus to contract more efficiently

what is uterine atony?

inadequate contraction of myometrial cells in response to endogenous oxytocin -- uterine atony causes the uterus to be unable to contract and stop postpartum bleeding

what are maternal s/s of herpes simplex virus

painful genital lesions and may be on external or internal genitalia

What are the S/S of mastitis?

painful, red, and tender breasts s/s of infection - flu-like symptoms

how do we test for HPV?

pap smear

which glands are usually affected in mumps?

parotid/salivary glands mumps think "bumps" b/c it leads to HUGE bumps in the cheeks (parotid/salivary glands)

which age group is most affected by erythema infectiosum?

passed from infected children (mostly school aged 4 yr old-18 yr old)

what are some predisposing factors for mastitis?

include inadequate emptying of breasts (engorgement, plugged milk duct), sudden decrease in # of feedings per day or abrupt weaning), sore, cracked nipples, underwire bras

what are the goals for treating postpartum hemorrhage?

increasing contractility and minimizing blood loss

how is rubella (german measles) transmitted?

infection spread through nasopharyngeal secretions or transplacentally

what virus causes erythema infectiosum (fifths disease)?

Human Parovirus B 19

what are the side effects of Methylergonovine (Methergine)?

Hypertension, nausea, vomiting, headache no in methylergonovine is no fever

is the varicella vaccine safe for pregnant patients?

Live virus vaccine = cant be given during pregnancy

what is congenital varicella syndrome?

it causes congenital varicella syndrome -- limb dysplasia, microcephaly, cortical atrophy, chorioretinitis, cataracts, cutaneous scars, auditory nerve palsy, motor & cognitive delays.

What is toxoplasmosis caused by?

its a parasitic infection caused by Toxoplasma gondii

what solutions would be used when administering fluid replacement therapy to a patient with hemorrhagic shock?

lactated ringers and blood type blood products

how should we position our patient experiencing hemorrhagic shock?

left side lying HOB DOWN (elevating the head can decrease blood to the brain)

what infection is treated with gentamicin and what are two adverse effects that can occur in the baby from gentamicin?

listeriosis nephrotoxicity and ototoxicity

if mom gets infected with listeriosis during pregnancy, how can this impact the fetus?

Maternal infection associated with spontaneous abortion, preterm birth, and fetal death

whats the maximal time that subinvolution of the uterus occurs?

Maximal time of occurrence is the 2nd week postpartum

What can Cytomegalovirus cause in infants?

low birth weight IUGR microcephaly CNS malformations cerebral calcifications deafness seizures petechial rash chorioretinitis

what effects does hepatitis B virus have on fetus?

May be asymptomatic at birth, more than 90% of infants infected perinatally develop chronic Hep B infection. clinical hepatitis, jaundice, changes in liver function, possible fulminant hepatitis.

what effects does hepatitis B virus have on mom?

low-grade fever, nausea, anorexia, jaundice, hepatomegaly preterm labor and preterm delivery.

what are the effects of HIV/AIDS on mom?

May be asymptomatic for years or have Mononucleosis-like symptoms such as fever, fatigue, sore throat, and lymphadenopathy since HIV suppresses the immune systems ability to fight infection

how does the zika virus affect fetus?

Microcephaly*** this is the big one Microcephaly is caused by zika virus because its transmitted through Mosquitoes (M - M) hearing and vision problems, joints with limited ROM, seizures, too much muscle tone (restricting body movements), swallowing abnormalities, possible developmental delays

how can we test the baby of a mom with HIV to see if the baby has it too?

Moms produce IGG antibodies to HIV virus. If you test baby within 18 months of life, then baby will test positive for antibodies from mom so its not reliable to tell us if baby has HIV.

after the first characteristic of erythema infectiosum, whats the next clinical manifestations?

maculopapular lacey rash on upper and lower extremities (not on trunk) Other sx are usually mild fever, runny nose, headache

which of the following would be S/S of strep throat? SATA 1. scarlartiniform rash 2. tonsillar enlargement 3. cervical node enlargement 4. palatal petechiae 5. maculopapular rash 6. geographical tongue 7. strawberry tongue 8. rhinorrhea 9. cough

1. scarlartiniform rash 2. tonsillar enlargement 3. cervical node enlargement 4. palatal petechiae 6. geographical tongue 7. strawberry tongue

Your patient stands up and there is a large pool of blood on the floor. What should the nurse do?

1. massage fundus to see if firm or boggy. if boggy, continue to massage. 2. Call for help if fundus is firm 3. Assist patient back to bed 4. Ask staff to call provider 5. Ask family members to leave the room except for partner who is seated 6. Assess fundus for size and firmness—massage if boggy 7. Assess for continued bleeding/clots 8. Assess bladder—may need I&O catheter 9. Ask staff to take vital signs

What will the care priorities by in the postpartum period after a patient had hemorrhagic shock?

- Anticipate anemia and its treatment (oral and/or parenteral iron) -transfusion if hemoglobin <7*** know this

what causes subinvolution of the uterus?

- Delayed or incomplete sloughing of the lining at the site - Delayed closure of the spiral arteries in the myometrium below the placental site (arteries still there to try to get blood from placenta to baby)

nursing interventions for mumps

-Provide bedrest -Avoid foods that are hard to chew -Apply hot or cold compresses to the neck

Name the maternal infections TORCH represents

-Toxoplasmosis -Others (hep B, HIV, Parvovirus, Westnile) -Rubella -Cytomegalovirus -Herpes simplex virus

A postoperative cesarean client, who was diagnosed with severe preeclampsia in labor and delivery is transferred to the postpartum unit. The nurse is reviewing the client's doctors orders. Which of the following medications that were ordered by the doctor should the nurse question? 1. methergine (methylergonovine) 2. mag sulfate 3. advil 4. morphine sulfate

1. methergine (methylergonovine) methylergonovine cannot be administered to patients with preeclampsia or cardiac disease

how does gonorrhea effect a fetus? SATA 1. opthlamitis 2. neonatal gonococcal arthritis 3. chorioretinits 4. septicemia 5. CNS anomalies 6. meningitis

1. opthlamitis 2. neonatal gonococcal arthritis 4. septicemia 6. meningitis MOSA

which of the following patients would be contraindicated to receive Methylergonovine (Methergine)? 1. patient with cardiac disease 2. patient with diabetes 3. patient with preeclampsia 4. patient with myasthenia gravis

1. patient with cardiac disease 3. patient with preeclampsia these patients would have high blood pressure, which is not allowed for methylergonovine

How does West Nile Virus present in mom?

majority of clinical disease is asymptomatic but can include fever, arthralgia, and myalgia.

What are the nursing interventions (in order) for treating a patient with postpartum hemorrhage?

1. Call for help and let another nurse contact OB---do not stop massaging the fundus 2. Assure IV access using 18 g for fluid replacement 3. Provide oxygen via nonrebreather mask, as ordered --> esp. if they have lost a lot of blood since the oxygen carrying capacity decreases when theres less blood

Which after birth conditions are considered medical emergencies that require immediate treatment? 1. Inversion of the uterus and hypovolemic shock 2. Subinvolution of the uterus and idiopathic thrombocytopenic purpura 3. Uterine atony and disseminated intravascular coagulation (DIC) 4. Hypotonic uterus and coagulopathies

1. Inversion of the uterus and hypovolemic shock Inversion of the uterus and hypovolemic shock are considered medical emergencies. A hypotonic uterus can be managed with massage and oxytocin. Coagulopathies should be identified before delivery and treated accordingly. Although subinvolution of the uterus and idiopathic thrombocytopenic purpura (ITP) are serious conditions, they do not always require immediate treatment. ITP can be safely managed with corticosteroids or IV immunoglobulin. Disseminated intravascular coagulation (DIC) and uterine atony are very serious obstetric complications; however, uterine inversion is a medical emergency requiring immediate intervention.

which of the following is associated with congenital varicella syndrome? 1. Limb dysplasia 2. congenital heart defects 3. Microcephaly 4. Cataracts 5. cutaneous rash 6. Chorioretinitis

1. Limb dysplasia 3. Microcephaly 4. Cataracts 6. Chorioretinitis

The parents of a boy who is diagnosed with mumps ask the nurse whether there is any special care that they should provide their child. Which of the following responses would be appropriate for the nurse to provide? Select all that apply. 1. Offer soft foods for the child to eat. 2. Encourage the child to drink citrus fruit juices each day. 3. Monitor the child carefully for signs of testicular discomfort. 4. Place an ice collar or warm compresses around the child's neck. 5. Administer ordered antihistamines for the full course of the disease.

1. Offer soft foods for the child to eat. 3. Monitor the child carefully for signs of testicular discomfort. 4. Place an ice collar or warm compresses around the child's neck. antihistamines are for chickenpox

Methylergonovine (Methergine) is prescribed for a client with postpartum hemorrhage. Before administering the medication, the nurse contacts the HCP who prescribed the medication if which of the following conditions is documented in the clients medical history? 1. Peripheral vascular disease 2. Hypotension 3. Hypothyroid 4. Type 1 diabetes

1. Peripheral vascular disease this med needs to be avoided in patients with HTN, which can include preeclampsia and cardiac disorders.

Nursing Care for Hepatitis B in Mom and Neonate

1. remove maternal blood from neonate immediately after birth 2. suction fluids out of newborn immediately after birth 3. bathe neonate before any invasive procedures 4. erythromycin 5. HBIG and Hep B vaccine 6. Discourage mom from kissing neonate until baby has received the vaccine

A woman infected with the human immunodeficiency virus (HIV) has given birth to an infant who appears normal, and the nurse provides instructions about newborn infant care. Which statement by the mother indicates an understanding of the instructions? Select all that apply. 1."I am going to need to bottle-feed my baby." 2."I need to wash my hands before and after bathroom use." 3."I can transmit the infection to my baby when I breast-feed." 4."My baby won't need any medication to prevent the virus because my baby appears normal." 5."I am going to contact some support groups to help me cope and learn ways to deal with things when I get home."

1."I am going to need to bottle-feed my baby." 2."I need to wash my hands before and after bathroom use." 3."I can transmit the infection to my baby when I breast-feed." 5."I am going to contact some support groups to help me cope and learn ways to deal with things when I get home."

An infant of a mother infected with human immunodeficiency virus (HIV) is seen in the clinic each month and is being monitored for symptoms indicative of HIV infection. With knowledge of the most common opportunistic infection of children infected with HIV, the nurse assesses the infant for which sign? 1.Cough 2.Liver failure 3.Watery stool 4.Nuchal rigidity

1.Cough The most common opportunistic infection of children infected with HIV is Pneumocystis jiroveci pneumonia.

what are some of the signs that a patient with west nile virus developed encephalitis or meningitis?

mental confusion, lethargy, photophobia, headache, muscle weakness, & coma, leading to death.

how long is the incubation period for varicella (chickenpox)?

10-21 days

whats the appropriate dose range for oxytocin?

10-40 units IV per 1000 mL or 10 units IM

when is pregnant patient at most risk of rubella infection?

12 week (first trimester) -- if it occurs during first 12 weeks of pregnancy, theres a high risk of congenital defects

What are the maternal effects of toxoplasmosis?

most are asymptomatic but may cause fatigue, muscle pains, pneumonitis, myocarditis, and lymphadenopathy (esp. of submandibular nodes)

you walk into your patients room and they are bleeding. you suspect postpartum hemorrhage. What should you do first? 1. Call the provider 2. Fundal Massage 3. Document 4. Do a vaginal exam

2. Fundal Massage Always do fundal massage before calling the provider

A newborn infant of a mother who has human immunodeficiency virus (HIV) infection is tested for the presence of HIV antibodies. An enzyme-linked immunosorbent assay (ELISA) is performed, and the results are positive. Which is the correct interpretation of these results? 1.Positive for HIV 2.Indicates the presence of maternal infection 3.Indicates that the newborn will develop acquired immunodeficiency syndrome (AIDS) later in life 4.Positive for AIDS

2.Indicates the presence of maternal infection

After birth women experience an increased risk for urinary tract infection. A prevention measure the nurse could teach the after birth woman would be to: 1. acidify the urine by drinking three glasses of orange juice each day. 2. maintain a fluid intake of 1 to 2 L/day. 3. perform perineal care on a regular basis. 4. empty her bladder every 4 hours throughout the day.

3. perform perineal care on a regular basis. Urine is acidified with cranberry juice. The woman should drink at least 3 L of fluid each day. The woman should empty her bladder every 2 hours to prevent stasis of urine. Keeping the perineum clean will help prevent a urinary tract infection.

A 10-month-old infant has been exposed to chickenpox. The nurse would expect the baby's primary health-care provider to order which of the following interventions to prevent the baby from contracting the illness? 1. Intravenous antibiotics 2. Varicella zoster immune globulin 3. Varicella immunization 4. Nothing because the baby is protected by the mother's antibodies

2.VIVG-avaccineisntgoingtohelpachildwhowasalreadyexposedtochickenpox

Dinoprostone (Prostin E2) - whats the correct dosage? how it is administered?

20 mg vaginal or rectal suppository given q2h

The priority nursing intervention when a nurse observes profuse after birth bleeding is to: 1. call the woman's primary health care provider. 2. administer the standing order for an oxytocic. 3. palpate the uterus and massage it if it is boggy. 4. assess maternal blood pressure and pulse for signs of hypovolemic shock.

3. palpate the uterus and massage it if it is boggy.

Which of the following circumstances is most likely to cause uterine atony and lead to PP hemorrhage? 1. hypertension 2. cervical and vaginal tears 3. urine retention 4. endometriosis

3. urine retention distended bladder --> hemorrhage

what patient populations would be contraindicated with methylprostaglandin (Hemabate)?

patients with asthma and patients with hypertension think methylprostaglandin is the only drug with an A in it, so its contraindicated for patients with Asthma

which of the following complications is most likely responsible for a delayed postpartum hemorrhage? 1. Cervical laceration 2. Clotting deficiency 3. Perineal laceration 4. Uterine subinvolution

4. Uterine subinvolution late postpartum bleeding is often the result of subinvolution of the uterus options 1 and 2 cause immediate postpartum hemorrhage

The home care nurse is visiting a mother 1 week after she gave birth to an infant who is at risk for developing neonatal congenital syphilis. After teaching the mother about the signs and symptoms of this disorder, the nurse instructs the mother to monitor the infant for which findings? Select all that apply. 1.Loose stools 2.High-pitched cry 3.Vigorous feeding habits 4.A copper-colored skin rash 5.Mucopurulent nasal drainage (snuffles)

4.A copper-colored skin rash 5.Mucopurulent nasal drainage (snuffles) Signs and symptoms of congenital neonatal syphilis may be nonspecific initially, including poor feedings, slight hyperthermia, and "snuffles." By the end of the first week of life, a copper-colored maculopapular dermal rash typically is observed on the palms of the hands, on the soles of the feet, in the diaper area, and around the mouth and anus.

what patient population is most likely to develop strep throat?

most common in school age children but may occur in younger children, especially if they have contact with school-age children Most cases seen in children > 3 years old, but can happen in younger kids (If it happens in a kid less than 3 years of age, its most likely b/c their sibling is sick with strep throat)

there are more severe symptoms and higher mortality rates in infants whose mother develops varicella _____ days before to ___ days after birth

5 days before to 2 days after birth

postpartum hemorrhage is defined as a loss of more than: _____ mL blood after a vaginal birth ______ mL blood after a C section

500 ml of blood after vaginal birth 1000 ml after cesarean birth

what is uterine inversion?

Turning inside out of uterus --> uterus literally turns inside out Potentially life threatening

which types of coxsackie virus are associated with hand foot mouth disease?

Types A6 & A16 are associated hand-foot-mouth disease

Prodromal period of Rubeola (measles)

URI symptoms that last 4-5 days 3 C's: cough, coryza (inflammation of nasal issue) & conjunctivitis koplik spots *think koplik spots has an O in it, so it goes will rubeola since that also has an O in it*

when do we screen for hepatitis B virus in pregnant patients?

Universal screening during pregnancy HBV can be given during pregnancy so we need to continually test them for HBV

what medication is given to infants following delivery if mom has chlamydia?

erythromycin = given to all infants following delivery to prevent ophthalmia neonatorum (blindness)

whats the most common cause of uterine inversion?

excessive traction on a placenta that is still attached to the top of the uterus.

How does rash appear in Rubella? By what day does it typically go away by?

face first then body, usually gone by 3rd day

what assessment findings are consistent with endometriosis?

fever > 38 C tender uterus chills foul smelling lochia

What is Zika virus ? what two things spread it?

A virus spread through Aedes species mosquito bites and semen

A child who has been diagnosed with rubeola is being cared for at home. Which of the following actions should the nurse educate the parents to perform? A. Keep the lights in the childs room dimmed. B. Give the child oatmeal baths C. Administer antihistamines D. Maintain the child on contact isolation for one week

A. Keep the lights in the childs room dimmed. --- can help with conjunctivitis oatmeal baths and antihistamines are for chickenpox rubeola is airborne precautions

what are the S/S of rubella?

fever, arthralgia, HA (prodromal stage); lymphadenopathy, rash

Early postpartum hemorrhage is defined as a blood loss greater than: A. 500 mL in the first 24 hours after vaginal delivery. B. 750 mL in the first 24 hours after vaginal delivery. C. 1000 mL in the first 48 hours after cesarean delivery. D. 1500 mL in the first 48 hours after cesarean delivery.

A. 500 mL in the first 24 hours after vaginal delivery.

A school-age child, whose parents are accompanying him, has been admitted to the pediatric unit on droplet isolation. Which of the following should the nurse include in the admission information for this child? A. It is important that you wear a face mask whenever you leave your room B. I know it will be hard for you but your parents can only stay in your room for 15 minutes. C. You will hear a funny whooshing sound whenever the door opens because the air is kept from going into the hallway. D. Everyone who comes into your room will be wearing a cap, gown, and mask.

A. It is important that you wear a face mask whenever you leave your room D is wrong because droplet isolation does not require a cap and gown, just a mask

how does HPV impact the birthing process?

multiple warts may block birth canal necessitating a c section

The perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is: A. Uterine atony B. Uterine inversion C. Vaginal hematoma D. Vaginal laceration

A. Uterine atony Uterine atony is marked hypotonia of the uterus. It is the leading cause of postpartum hemorrhage.

The perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is: A. Uterine atony. B. Uterine inversion. C. Vaginal hematoma. D. Vaginal laceration.

A. Uterine atony.

which of the following is transmitted during the last trimester? SATA A. gonorrhea B. chickenpox C. chlamydia D. toxoplasmosis

A. gonorrhea C. chlamydia

When reviewing a prenatal record for a client at 32 weeks gestation, the nurse notes that the client was recently diagnosed with chlamydia. What will the nurse include in the client's teaching plan? (Select all that apply.) A.Call the clinic immediately if you feel any gush of fluid from your vagina. B.Call the clinic immediately if you have contractions every 5 minutes for an hour. C.Call the clinic immediately if you note an increase in non-painful reddened areas. D.Do not share needles with your sexual partners. E.Do not have sex for 7 days after you take your antibiotics.

A.Call the clinic immediately if you feel any gush of fluid from your vagina. B.Call the clinic immediately if you have contractions every 5 minutes for an hour. E.Do not have sex for 7 days after you take your antibiotics.

what trimester is the fetus most vulnerable to the effects of Rubella? What can Rubella do to the fetus?

first trimester deafness, eye defects, CNS anomalies, & severe cardiac malformations

what infections can lead to pelvic inflammatory disease?

gonorrhea and chlamydia

Methylergonovine (Methergine) - whats it used for? what patient would be it be contraindicated in?

Acts directly on the uterine muscle to stimulate forceful contractions. Used for postpartum hemorrhage. Should be avoided in patients with hypertension

how long would medication tx be for a baby who tested positive for herpes simplex virus?

Acyclovir RX for 6 months for neonates with HSV CNS disease. Can be given to mom during pregnancy as well

what infections do we report to health department?

gonorrhea, chlamydia and HPV

Jack, who has varicella, is missing his school friends and is eager to return to school. When should the nurse inform the school nurse that it would be safe for Jack to return to school? A whenever he feels strong enough B When, all the lesions have dried, and there are no new lesions. C as soon as his fever is within normal range D one week after he began the antibiotic

B When, all the lesions have dried, and there are no new lesions. A faster return to school will result in potential infections of other children. No antibiotics are given with varicella treatment. Having fever with varicella means the child is still infectious. Jack may have periods of fatigue and energy during the illness and will not indicate his degree of infectious state.

What is coxsackie virus?

group B enterovirus parechovirus

whats the best way to stop the nosocomial spread of listeriosis?

hand washing

what is the treatment of HPV in pregnancy?

Antiviral = acyclovir

Parent education for parvovirus 19

Any kids with fifths disease should not go to school. esp if teacher is pregnant. pregnant HCP should not care for patients who had may be highly contagious sich as child with sickle cell anemia or aplastic crisis, parvovirus

which infections cause fetal death?

Parvovirus, syphilis, west nile, and listeriosis "Penny Was Slaughtered Last"

A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination the nurse notices warmth and redness over an enlarged, hardened area. The nurse should suspect __________ and should confirm the diagnosis by ___________. A. Disseminated intravascular coagulation; asking for laboratory tests B. von Willebrand disease; noting whether bleeding times have been extended C. Thrombophlebitis; using real-time and color Doppler ultrasound D. Coagulopathies; drawing blood for laboratory analysis

C. Thrombophlebitis; using real-time and color Doppler ultrasound

What woman is at greatest risk for early postpartum hemorrhage? A. A primiparous woman (G 2 P 1 0 0 1) being prepared for an emergency cesarean birth for fetal distress B. A woman with severe preeclampsia on magnesium sulfate whose labor is being induced C. A multiparous woman (G 3 P 2 0 0 2) with an 8-hour labor D. A primigravida in spontaneous labor with preterm twins

B. A woman with severe preeclampsia on magnesium sulfate whose labor is being induced Magnesium sulfate administration during labor poses a risk for PPH. Magnesium acts as a smooth muscle relaxant, thereby contributing to uterine relaxation and atony.

Which woman is at greatest risk for early postpartum hemorrhage (PPH)? A. A primiparous woman (G 2 P 1 0 0 1) being prepared for an emergency cesarean birth for fetal distress B. A woman with severe preeclampsia who is receiving magnesium sulfate and whose labor is being induced C. A multiparous woman (G 3 P 2 0 0 2) with an 8-hour labor D. A primigravida in spontaneous labor with preterm twins

B. A woman with severe preeclampsia who is receiving magnesium sulfate and whose labor is being induced

How is rubella transmitted?

nasopharyngeal secretions and transplacental

would infants who are exposed postnatally to varicella zoster recieve VZIG?

no

A steady trickle of bright red blood from the vagina in the presence of a firm fundus suggests: A. Uterine atony. B. Lacerations of the genital tract. C. Perineal hematoma D. Infection of the uterus.

B. Lacerations of the genital tract.

Which STD can be transmitted anytime during pregnancy? A. gonorrhea B. chlamydia C. syphilis D. herpes simplex virus

C. syphilis gonorrhea and chlamydia are transmitted in third trimester and herpes simplex is transmitted at birth

Vitamin A supplementation may be recommended for which of the following conditions? A. mumps B. rubeola C. rubella D. erythema infectiosum

B. rubeola

A nurse is preparing a list of self-care instructions for a PP client who was diagnosed with mastitis (SATA): A. take prescribed antibiotics until soreness has stopped B. wear supportive bra C. Avoid decompression of the breasts by breastfeeding D. Rest E. Continue to breastfeed

B. wear supportive bra D. Rest E. Continue to breastfeed A is wrong b/c she needs to take her antibiotics until the course is over. C is wrong because she wants to decompress the breasts by breastfeeding.

what is listeriosis caused by?

Bacteria: Listeria monocytogenes

whats the medical management for endometriosis?

Broad spectrum antibiotic (eg. gentamicin, penicillin, clindamycin) and supportive care

Jack has rubella. A nurse is preparing to enter Jack's room. Because his infection also includes potential airborne in addition to contact precautions, what isolation precautions should the nurse use? A goggles and nonsterile gloves B gown and nonsterile gloves C mask, gown, and nonsterile gloves D no precautions provided Jack wears a mask

C mask, gown, and nonsterile gloves

whats the highest incidence of endometriosis from?

C section after prolong labor and rupture of membranes

Despite popular belief, there is a rare type of hemophilia that affects women of childbearing age. Von Willebrand disease is the most common of the hereditary bleeding disorders and can affect males and females alike. It results from a factor VIII deficiency and platelet dysfunction. Although factor VIII levels increase naturally during pregnancy, there is an increased risk for postpartum hemorrhage from birth until 4 weeks postdelivery as levels of von Willebrand factor (vWf) and factor VIII decrease. The treatment that should be considered first for the client with von Willebrand disease who experiences a postpartum hemorrhage is: A. Cryoprecipitate B. Factor VIII and vWf C. Desmopressin D. Hemabate

C. Desmopressin

how does the zika virus affect mom?

no effects known

A nurse is assessing a client in the fourth stage of labor and notes that the fundus is firm but that bleeding is excessive. The inital nursing action would be which of the following? A. Massage fundus B. Place mom in tredenlenberg position C. Notify the physician D. Record the findings

C. Notify the physician if fundus is firm as fundal massage is continuing, we need to notify HCP

The nurse is providing care to a newborn just delivered from a mom who is positive for Hepatitis B. What additional care will the nurse plan for this neonate? (Select all that apply.) A. Place the baby next to the mother's face, eye-to-eye, immediately after delivery. B. Delay the application of eye prophylaxis until 2 to 3 hours after birth. C. Remove any maternal blood from the infant immediately after birth. D. Bathe the neonate prior to administering the vitamin K injection. E. Perform a gastric lavage prior to initiating breastfeeding.

C. Remove any maternal blood from the infant immediately after birth. D. Bathe the neonate prior to administering the vitamin K injection. The baby must be cleaned from maternal blood immediately after birth to decrease the risk of newborn Hep B infections. Bathing the baby before the vitamin K will also decrease the risk of infection. Kissing the infant prior to the administration of the hepatitis vaccine is discouraged, to decrease the risk of infection, position the baby to decrease the face-to-face proximity of mother and infant. Perform eye prophylaxis after the face has been cleansed, no need to delay the application of the ointment. No need to perform gastric lavage. Breastfeeding is encouraged.

A mother with mastitis is concerned about breastfeeding while she has an active infection. The nurse should explain that: A. The infant is protected from infection by immunoglobulins in the breast milk. B. The infant is not susceptible to the organisms that cause mastitis. C. The organisms that cause mastitis are not passed to the milk. D. The organisms will be inactivated by gastric acid.

C. The organisms that cause mastitis are not passed to the milk.

infants with disseminated gonorrhea infection require cefotaxime for how long?

one week

The nurse is teaching care of the newborn to a childbirth preparation class and describes the need for administering antibiotic ointment into the eyes of the newborn. An expectant father asks, "What type of disease causes infections in babies that can be prevented by using this ointment?" Which response by the nurse is accurate? (Select all that apply.) A.Herpes B. Trichomonas C.Gonorrhea D.Syphilis E.Chlamydia F.Hepatitis B

C.Gonorrhea E.Chlamydia Erythromycin ointment is instilled into the lower conjunctiva of each eye within 2 hours after birth to prevent ophthalmia neonatorum, an infection caused by gonorrhea, and inclusion conjunctivitis, an infection caused by Chlamydia. The infant may be exposed to these bacteria when passing through the birth canal. Ophthalmic ointment is not effective against option A, B, D, and F.

Which infections Damage the babies? think of the mneumonic*

Can cute girls have little pets? Rabbits, snakes, zebras? Coxsackievirus Cytomegalovirus Gonorrhea Herpes Simplex Virus Listeriosis Parvovirus Rubella Syphilis Zika

What does parvovirus cause in the fetus?

Causes fetal hydrops and death from anemia and heart failure with early exposure Happy Days Are Here

what are the nursing considerations for Methylergonovine (Methergine)?

Check blood pressure before giving, and do not give if >140/90mm Hg; continue monitoring vaginal bleeding and uterine tone how can you remember this? think methylergonovine has "no" in it, so youll have to say "no" to administering this medication if the blood pressure is above 140/90 mm Hg

What patient population is most at risk for serious complications from communicable diseases?

Children with immunodeficiency

when is chlamydia transmitted from mom to baby?

Chlamydia trachomatis (bacteria) is transmitted is during the last trimester or perinatal period.

After how many days does varicella (chickenpox) take to become communicable?

Communicability is 1-2 days before rash develops

how should nurses handle care for infants with herpes simplex virus?

Contact precautions along with standard precautions should be observed b/c absence of lesions in an exposed neonate does not mean there is an absence of the disease.

When would varicella (chickenpox) be considered NOT contagious?

Contagious until lesions crust over and disappear

what are the nursing considerations for oxytocin?

Continue to monitor vaginal bleeding and uterine tone.

whats the purpose of given drugs for postpartum hemorrhage? what are these drugs known as?

Contraction of uterus to Decrease bleeding they are known as uterotonics

whats the characteristic lesions of congenital syphilis?

Copper colored maculopapular cutaneous lesions

when is coxsackie virus transmitted from mom to baby?

peripartum (shortly before, during, and after labor)

whats the surgical management for hemorrhagic shock?

D&C, hysterectomy

where does endometriosis originate?

placental site during postpartum period

One of the first symptoms of puerperal infection to assess for in the postpartum woman is: A. Fatigue continuing for longer than 1 week. B. Pain with voiding. C. Profuse vaginal bleeding with ambulation. D. Temperature of 38° C (100.4° F) or higher on 2 successive days starting 24 hours after birth.

D. Temperature of 38° C (100.4° F) or higher on 2 successive days starting 24 hours after birth.

how do we diagnose rubella?

Diagnosis is clinical & confirmed with PCR of nasal secretions

how is hepatitis B virus transmitted?

Direct contact with blood or body fluid from infected person, transplaccental

Nurses need to know the basic definitions and incidence data about postpartum hemorrhage (PPH). For instance: A. PPH is easy to recognize early; after all, the woman is bleeding. B. Traditionally it takes more than 1000 mL of blood after vaginal birth and 2500 mL after cesarean birth to define the condition as PPH. C. If anything, nurses and doctors tend to overestimate the amount of blood loss. D. Traditionally PPH has been classified as early or late with respect to birth.

D. Traditionally PPH has been classified as early or late with respect to birth. Early PPH is also known as primary, or acute, PPH; late PPH is known as secondary PPH. Unfortunately PPH can occur with little warning and often is recognized only after the mother has profound symptoms. Traditionally a 500-mL blood loss after a vaginal birth and a 1000-mL blood loss after a cesarean birth constitute PPH. Medical personnel tend to underestimate blood loss by as much as 50% in their subjective observations.

When caring for a postpartum woman experiencing hemorrhagic shock, the nurse recognizes that the most objective and least invasive assessment of adequate organ perfusion and oxygenation is: A. Absence of cyanosis in the buccal mucosa. B. Cool, dry skin. C. Diminished restlessness. D. Urinary output of at least 30 mL/hr.

D. Urinary output of at least 30 mL/hr.

The nurse is providing care to a client who just delivered her sixth term infant. In addition to routine postpartum care, what additional priority nursing action will the nurse include in this client's plan of care? A. Use warm water in the peri bottle to cleanse the peri area after birth. B.Perform fundal assessments every 15 minutes for the first hour after delivery. C.Bring the siblings in to see the newborn at two hours after delivery. D.Weigh the peri pads before and after placement to the peri area.

D. Weigh the peri pads before and after placement to the peri area. This client is at risk for postpartum hemorrhage (PPH). One gram of blood equals one mL of blood loss. Pre and post weighing the peri pad will give a better estimate of blood loss (EBL) after delivery. Warm water to the peri area is a comfort measure, but not as important as the EBL. Fundal massage for this client should be more frequent than every 15 minutes as she is at risk for PPH. Sharing time with siblings is psychosocial; physical needs take priority over psychosocial needs.

Which of the following are not transplacental tranmission? SATA A. toxoplasmosis B. Hep B C. HIV D. West Nile E. Herpes Simplex Virus F. HPV G. listeriosis

D. West Nile E. Herpes Simplex Virus F. HPV

how do we confirm a diagnosis of Varicella (chickenpox)?

DFA PCR

how is west nile virus diagnosed? why are diagnostics for west nile not reliable?

Diagnosed with antibodies to the virus are present in serum or CSF. These IGG antibodies can be found 3-8 days after illness onset and persists 1-3 months. Positive results may reflect past infection rather than current (IGG), this is why the test results may not be 100% reliable because the patient can test positive even though they dont have a current infection.

whats a diagnosis of congenital syphilis dependent on?

Dx evaluation depends upon maternal serology testing.

whats the most common postpartum infection?

Endometritis - inflammation of the inner lining of the uterus

What is parvovirus B19?

Erythema infectiosum (fifth disease) but in babies!

why do we apply prophylactic medication to a newborns eyes at time of birth?

Erythromycin on eyes to treat any possible gonorrheal infections since it can cause blindness

whats the medication to treat syphilis?

Penicillin G (only treatment for syphilis)

what are the nursing interventions for hemorrhagic shock?

Fundal massage Positioning Maintain intravenous access

whats the first step in evaluating the contractility of uterus?

Fundal massage, fundal massage, fundal massage**** -> fundal massage increases contractility to stop bleeding

which group strep usually causes strep throat AKA bacterial pharyngitis?

Group A Strep (GABHS)

how do we treat newborns with hepatitis B virus?

HBIG and Hepatitis vaccine at birth.

Dinoprostone (Prostin E2) side effects

Headache, nausea and vomiting, fever, chills, diarrhea

what are the side effects of Misoprostol (Cytotec)?

Headache, nausea, vomiting, diarrhea, fever, chills May cause a low-grade fever. It has a delayed action.

what drug is used to treat ophthlamia and nondisseminiated infection from gonorrhea?

IM or IV ceftriaxone once

what drug would be given for neonatal infections of coxsackie virus

IVIG

whats the chance of recurrence in a mom who had an episode of hemorrhagic shock with a previous child?

If she had a previous hypovolemic shock during pregnancy, it has a 15% chance of happening again

how do we confirm diagnosis of rubeola (measles)?

IgM antibody level think O in antibody and rubeola

what happens when an infant is confirmed to have gonorrhea?

Infant with confirmed infection should be hospitalized and cultured to determine antibiotic RX

whats the difference in clinical manifestations between term and preterm infants who are exposed to cytomegalovirus?

Infected at birth or breastfeeding, they typically wont have many S/S of illness. But if they are exposed preterm then they can develop interstitial pneumonia

what patient population does mumps infection typically occur in?

Infection usually occurs when children are under vaccinated

what are some side effects of oxytocin?

Infrequent: water intoxication, nausea and vomiting The rapid undiluted infusion may cause hypotension.

what are the S/S of strep throat?

Isn't always sore throat and fever! --> Headache vomiting stomachache

what is accidentally done by nurses that can cause uterine inversion?

It theoretically could be caused by excessive pressure on the fundus during massage right after delivery, which is why it is IMPORTANT to support the lower uterus when massaging. - One hand above fundus and on suprapubic area to prevent uterine inversion.

whats the risk of erythema infectiosum? does it cause serious illness? who could become really sick if exposed (3 patient populations)?

Limited risk except for those with immunosuppression, aplastic anemia, or are pregnant (2nd trimester) Pregnant women should avoid the infected individual

what are the s/s of cytomegalovirus in mom during pregnancy?

Most asymptomatic but may have s/s of mononucleosis like syndrome

What is West Nile Virus?

Most common arbovial disease in the US. Transmission occurs between arthropods and their hosts usually small mammals or birds.

what are the S/S of gonorrhea in mom?

Most women have no symptoms but may have burning with urination, increased purulent yellow-green discharge or bleeding between periods. Rectal infection can cause anal itching, discharge and bleeding.

what can cause subinvolution of the uterus and uterine atony?

Multiparity and Multigestation Polyhydramnios Retained placental parts Placenta accreta

what causes gonorrhea?

Neisseria gonorrhoeae bacteria

how would we educate a pregnant patient with herpes about her labor?

No active lesions, can deliver vaginally - if lesions, need to be C section

who are the first people to recognize the S/S of communicable diseases?

Nurses in ambulatory settings, childcare centers and schools

what are the s/s of HPV in a fetus?

Possible chronic respiratory papilomatosis (papules in lungs) think hPv and p for papilomatosis

what are the herpes simplex virus effects on a fetus?

SEM (Skin, Eyes, & Mouth) involvement, causing skin infections localized CNS disease disseminated disease involving multiple organs

when do we screen pregnant patients for chlamydia?

Screen (with GC) at initial prenatal, at 28 weeks and again at delivery

How is postpartum hemostasis achieved?

Postpartum hemostasis is achieved by compression of the intramyometrial blood vessels in the uterus after birth to prevent postpartum hemorrhage- i.e. fundal massage

what are signs of early listeriosis vs late listeriosis?

Preterm birth, sepsis, & pneumonia seen in early onset disease late onset disease usually manifests as meningitis

primary vs secondary postpartum hemorrhage

Primary postpartum hemorrhage is within 24 hours after birth, secondary postpartum hemorrhage is after 24 hours of birth

Contact precautions have what 5 things?

Private room - door can be open Gloves Gown- if giving direct care Handwashing Disposable supplies Dedicated equipment

when is erythema infectiosum no longer contagious

Probably not contagious after the rash appears

what are the two stages of Rubeola (Measles)?

Prodromal Period and Rash Stage

what are the two stages of mumps?

Prodromal stage = first start getting symptoms- Fever, headache, malaise, anorexia, jaw or ear pain thats aggravated by chewing Swelling stage = when the salivary glands swell up (very painful) --> difficulty chewing because cheeks become swollen, which can lead to anorexia since they wont eat

what are the early signs of a postpartum hemorrhage?

Rising uterus (U --> U+1, etc.) Increase lochia - pad is soaked in 15 minutes Vital signs - increased pulse and decreased BP

what is subinvolution of the uterus? Whats the pathophysiology as to why it can cause postpartum hemorrhage?

Subinvolution is when the uterus does not return to prepregnant state. Subinvolution is usually related to a healing problem at the site of the placenta.

what care is given to a patient with varicella-zoster virus?

Supportive care to decrease itching, fever, with Benadryl and Tylenol.

how do we diagnose herpes simplex virus in mom?

Swabs of all lesions, mouth, nasopharynx, conjunctivae, rectum, and specimens of urine stool, blood, CSF should be sent for culture

whats the treatment for mastitis?

TX with antibiotics, antipyretics, increase breastfeeding or pumping, warm compresses before feeding or pumping.

What is the postpartum period?

The postpartum period is one in which the woman adjusts physically and psychologically to her pregnancy and birth. It begins after delivery and lasts for approximately 6 weeks. During this time, the woman's body returns to a near pre-pregnant state.

what patient education would we provide to a mom with HIV who is pregnant?

They cannot breastfeed since HIV can be transmitted through breastmilk.

what are the maternal s/s of chlamydia?

Three fourths of women have no s/s so it is known as silent disease but may have burning with urination or vaginal discharge

when is transmission of varicella zoster from mom to baby? how does it affect the baby?

Transmission in first trimester causes fetal varicella syndrome -- defects perinatal period causes infection

How is herpes simplex virus transmitted from mom to fetus?

Transmission is contact at delivery and ascending infection via ruptured membranes. (not transplacental)

How is gonorrhea transmitted from mom to baby?

Transmission last trimester or perinatal period

How is west nile virus transmitted?

Transmitted by infected mosquitoes or ticks (when they bite humans)

how is toxoplasmosis transmitted?

Transplacental raw undercooked meats and cat feces cause it

how is listeriosis transmitted from mom to baby?

Transplacental transmission by ascending infection by ruptured membranes or exposure at birth

what organism causes congenital syphilis?

Treponema palladium (bacteria)

what viral group does cytomegalovirus belong to?

herpes virus

what medications are used to treat infants born to mothers with onset of disease within 5 days before or 2 days after birth?

Use varicella zoster immune globulin (VZIG) - only used in newborns who are immuncompromised in that 5 days before or 2 day after range. All other newborns should NOT get VZIG

Dinoprostone (Prostin E2) contraindications or caution

Use with caution in women with asthma, hypertension, and hypotension

whats the process of uterine involution after childbirth?

Uterine involution is when the uterus shrinks back to its pre pregnancy state by 6 weeks. It begins right after expulsion of placenta and continues during the postpartum period. 24 hours after delivery the fundal height is measured at the umbilicus and should reduce in height approximately 1 cm a day until the uterus returns to the prepregnant state- but sometimes it takes a little longer.

whats the medical management for hemorrhagic shock?

Uterotonic agents Surgery

how often do we check the HIV viral load in pregnant patients?

Viral loads during each trimester should be completed

what are the s/s of HPV in mom?

Warts, painful urination, foul smelling discharge, tired

Can we give mom the MMR vaccine during pregnancy?

We cannot give them MMR during pregnancy because it's a live virus vaccine. We will give them the vaccine after pregnancy is over

a patient has just recovered from postpartum hemorrhage and wants to walk around to go to the bathroom- whats the appropriate nursing intervention?

We put her on a bedpan to have her go to the bathroom, don't let her walk around to get to the bathroom that's not safe!

How can we determine based on the HIV viral load if the mom can deliver vaginally or C section?

if less than 1000 she can deliver vaginally. If greater than 1000, she has to have C section

During a prenatal examination, the woman reports having two cats at home. The nurse informs her that she should not be cleaning the litter box while she is pregnant. When the woman asks why, the nurse's best response would be: a. "Your cats could be carrying toxoplasmosis. This is a zoonotic parasite that caninfect you and have severe effects on your unborn child." b. "You and your baby can be exposed to the human immunodeficiency virus (HIV)in your cats' feces." c. "It's just gross. You should make your husband clean the litter boxes." d. "Cat feces are known to carry Escherichia coli, which can cause a severeinfection in both you and your baby."

a. "Your cats could be carrying toxoplasmosis. This is a zoonotic parasite that caninfect you and have severe effects on your unborn child."

Which intervention is appropriate for a hospitalized child with crops of lesions in the trunk and appear as a macular rash with vesicles? a. Place the child in strict isolation; airborne and contact precautions. b. Continue to practice Standard Precautions. c. Pregnant women should avoid contact with the child. d. Screen visitors for immunity to measles.

a. Place the child in strict isolation; airborne and contact precautions. A The child's skin lesions are characteristic of varicella. Varicella is transmittedthrough direct contact, droplets, and airborne particles. In the hospital setting,children with varicella should be placed in strict isolation, and on Contact andAirborne Precautions. The purpose is to prevent transmission of microorganismsby inhalation of small-particle droplet nuclei and to protect other patients andhealth care providers from acquiring this disease.B The child's skin lesions are characteristic of varicella. Additional measures mustbe instituted to protect other patients and staff who may be susceptible to thedisease.C Certain viral illnesses such as rubella and fifth disease are known to affect thefetus if the woman contracts the disease during pregnancy. This child appears tohave varicella. Pregnancy is not a contraindication to caring for a child withvaricella.D The child appears to have varicella. Screening visitors for immunity to measles isirrelevant. It is important to screen visitors for immunity to varicella.

whats the medication choice for herpes simplex virus? both mom and baby

acyclovir -- Prevent active breakout treat mom predelivery

what are the risk factors for subinvolution of the uterus?

advanced maternal age and multiparity but the precise etiology is unknown

what kind of precautions would be used for a patient who has mumps?

airborne, droplet, contact precautions

what antibiotics are used to treat newborns infected with listeriosis?

ampicillin and an aminoglycoside such as gentamycin

how do we treat cytomegalovirus in newborns? how long do we give them this med for?

antivirals for 6 weeks in newborns who test positive

what is puerperal sepsis?

any infection of genital tract within 28 days after miscarriage, induced abortion, or birth

how long should a patient who just recieved the MMR vaccine wait to get pregnant?

avoid contraception for 3 months.

how do we manage chlamydia during pregnancy? what drug?

azithromycin

The client who is being treated for endometritis is placed in Fowler's position because it: a. promotes comfort and rest. b. facilitates drainage of lochia. c. prevents spread of infection to the urinary tract. d. decreases tension on the reproductive organ

b. facilitates drainage of lochia. foul smelling lochia is a sign of endometriosis

A multiparous woman is admitted to the postpartum unit after a rapid labor and birth of a 4000 g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The nurse has the woman void and massages her fundus, but her fundus remains difficult to find, and the rubra lochia remains heavy. The nurse should: a. continue to massage the fundus. b. notify the physician. c. recheck vital signs. d. insert a Foley catheter.

b. notify the physician.

what can be taught to mom about things she can do to prevent postpartum hemorrhage?

breastfeeding! Something she can do, at home, to help facilitate uterine involution.

whats the first characteristic of erythema infectiosum?

bright red "slapped face" rash mainly on the cheeks.

how do we diagnose mumps

buccal swab

A primigravida has just delivered a healthy infant girl. The nurse is about to administer erythromycin ointment in the infant's eyes when the mother asks, "What is that medicine for?" The nurse responds: a. "It is an eye ointment to help your baby see you better." b. "It is to protect your baby from contracting herpes from your vaginal tract." c. "Erythromycin is given prophylactically to prevent a gonorrheal infection." d. "This medicine will protect your baby's eyes from drying out over the next few days"

c. "Erythromycin is given prophylactically to prevent a gonorrheal infection."

Which nursing measure would be appropriate to prevent thrombophlebitis in the recovery period after a cesarean birth?a. Roll a bath blanket and place it firmly behind the knees. b. Limit oral intake of fluids for the first 24 hours. c. Assist the client in performing leg exercises every 2 hours. d. Ambulate the client as soon as her vital signs are stable.

c. Assist the client in performing leg exercises every 2 hours.

Near the end of the first week of life, an infant who has not been treated for any infection develops a copper-colored, maculopapular rash on the palms and around the mouth and anus. The newborn is showing signs of: a. gonorrhea. b. herpes simplex virus infection. c. congenital syphilis. d. human immunodeficiency virus.

c. congenital syphilis.

Nursing measures that help prevent postpartum urinary tract infection include: a. promoting bed rest for 12 hours after delivery. b. discouraging voiding until the sensation of a full bladder is present. c. forcing fluids to at least 3000 mL/day. d. encouraging the intake of orange, grapefruit, or apple juice.

c. forcing fluids to at least 3000 mL/day.

what are the maternal effects of syphilis?

chancre sores, then maculopapular rash advancing to CNS and multiorgan damage.

if a baby is positive for gonorrhea, what else would you consider testing for?

chlamydia, HIV, & syphilis

how does chlamydia effect a fetus?

conjunctivitis and pneumonia

what is considered early interventions for postpartum hemorrhage?

count blood loss as it happens and fundal massage

which congenital infection can we see affected individuals excrete virus and can be detected in urine or tissue?

cytomegalovirus

Which statement by a postpartal woman indicates that further teaching is not needed regarding thrombus formation? a. "I'll stay in bed for the first 3 days after my baby is born." b. "I'll keep my legs elevated with pillows." c. "I'll sit in my rocking chair most of the time." d. "I'll put my support stockings on every morning before rising."

d. "I'll put my support stockings on every morning before rising."

Which temperature indicates the presence of postpartum infection? a. 99.6° F in the first 48 hours b. 100° F for 2 days postpartum c. 100.4° F in the first 24 hours d. 100.8° F on the second and third postpartum days

d. 100.8° F on the second and third postpartum days remember = the first 24 hours after birth mom may have a fever, thats normal. After those 24 hours, it would be abnormal.

which of the following is transmitted peripartum? a. syphilis b. cytomegalovirus c. chickenpox d. coxsackievirus

d. coxsackievirus

Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. The nurse would suspect: a. bladder distention. b. uterine atony. c. constipation. d. hematoma formation

d. hematoma formation Bladder distention would result in an elevation of the fundus above the umbilicus and deviation to the right or left of midline. Uterine atony would result in a boggy fundus. Constipation is unlikely at this time. Increasing perineal pressure along with a firm fundus and moderate lochial flow are characteristic of hematoma formation.

Human immunodeficiency virus (HIV) may be perinatally transmitted: a. only in the third trimester from the maternal circulation. b. by a needlestick injury at birth from unsterile instruments. c. only through the ingestion of amniotic fluid. d. through the ingestion of breast milk from an infected mother.

d. through the ingestion of breast milk from an infected mother.

what are the side effects of methylprostaglandin (Hemabate)?

diarrhea, fevers, or tachycardia headache, n/v, hypertension

What medication can be used to help with the itchiness of chickenpox?

diphenhydramine (benadryl)

how is varicella (chickenpox) transmitted?

direct contact, droplets and airborne transmission -- why we do complete isolation for children with chickenpox

Droplet vs airborne precautions

droplet - regular mask airbone - n95

nursing care for rubella

droplet precautions reassure parents of benign nature of this illness in child avoid contact with pregnant woman

what trimester does parvovirus cause the most serious effects?

during the first trimester

how can we prevent HIV/AIDS transmission from mom to fetus?

early antiretroviral treatment

whats the neuroinvasive form of west nile? does this form affect the mom or the fetus?

encephalitis, menigitis, & acute flaccid paralysis, headache, photophobia, etc. it affects the mom

what are the S/S of rubella in mom?

erythematous maculopapular rash, lymph node enlargement, slight fever, headache, and malaise.