AWHONN POEP Module 10 (2023/2024) Rated A+

AWHONN POEP Module 10 (2023/2024) Rated A+ Universal vaccination and prenatal testing for hepatitis B have decreased the incidence of acute hepatitis infections in newborns. Neonates born to hepatitis B surface-antigen (HBsAg)-positive mothers should receive Hep V vaccine and HBIG within 12 hours of birth; Diagnostic testing 1-3 months A pregnant woman presents with a rash two days before giving birth to a full term neonate. The rash is determined to be caused by the varicella-zoster virus. Which complications will the newborn most likely experience? Life-threatening disseminated disease Lorna, a 22 year old, presenting to the clinic for her annual examination. Lorna and her husband are planning to start a family. She shares that her friend was newly diagnosed with HPV. Lorna asks you how she would know if she had HPV. Your best response would be Most HPV infections are asymptomatic, unrecognizable, or clinically unremarkable You are caring for Carla, a 23 year old G1P0 who is being induced for post dates. Carla has a history of herpes simplex virus but no active lesions at this time. The fetal heart rate (FHR) is very difficult to trace. You have to consistently adjust the ultrasound to obtain the FHR. One of the nursing students on the unit asks why you don't place a fetal scalp electrode. Your best response is The application of a fetal scalp electrode is not generally recommended for women with active lesions or a history of HSV infection because it can cause a local neonatal infection. Karen is being treated for trichomoniasis and is prescribed a single 2 gram dose of oral metronidazole. What should you include in the education to Karen. (Select all that apply.) Avoid alcohol or vinegar products because they may cause nausea, vomiting, or cramping. Avoid sexual intercourse for at least two weeks to allow the tissues to heal. Continue to avoid alcohol for at least 24 hours after you take the metronidazole. You will need to return in three months for retesting. (All are true) Avoid alcohol or vinegar products because they may cause nausea, vomiting, or cramping. Avoid sexual intercourse for at least two weeks to allow the tissues to heal. Continue to avoid alcohol for at least 24 hours after you take the metronidazole. You will need to return in three months for retesting. Antimicrobial ophthalmic prophylaxis given to the neonate soon after birth is recommended for which STI? Gonorrhea Pam is a 30 year old G4P4 who just had a vaginal birth of a term female. Pam is HIV positive and has been on ARV prophylaxis. She is wanting to know if she can breastfeed her baby. Your best response would be? (Select all that apply.) Although the exact mechanism of HIV transmission through breastmilk is not clear, HIV RNA can be detected in colostrum and breastmilk so breastfeeding is not recommended. HIV RNA cannot be detected in colostrum and breastmilk so it is safe to breastfeed. It is suggested that the portal of entry for breastmilk HIV transmission to be the newborn’s intestine or tonsillar tissues so breastfeeding is not recommended. The strong recommendation is avoidance of breastfeeding despite the reduction of risk of breastmilk postnatal transmission with ARV prophylaxis. Although the exact mechanism of HIV transmission through breastmilk is not clear, HIV RNA can be detected in colostrum and breastmilk so breastfeeding is not recommended. It is suggested that the portal of entry for breastmilk HIV transmission to be the newborn's intestine or tonsillar tissues so breastfeeding is not recommended. The strong recommendation is avoidance of breastfeeding despite the reduction of risk of breastmilk postnatal transmission with ARV prophylaxis. Monica is a 28 year old G5P1 at 39 2/7 weeks gestation who presents to the L&D unit in active labor. She has had limited prenatal care due to issues with transportation. Monica tells you that she is HIV positive and has been taking ARV as prescribed. From your training you have received, you know that additional measures to reduce HIV transmission include? (Select all that apply.) Avoiding artificially rupturing Monica's membranes. Avoiding the use of a fetal scalp electrode. Prepare for a cesarean birth. Prepare for an operative vaginal birth. Avoiding artificially rupturing Monica's membranes. Avoiding the use of a fetal scalp electrode. Match the STI with the neonatal complications. Syphilis Clinical signs and symptoms may include an edematous "barber's pole" umbilical cord with stripes of red, light blue, and chalky white Match the STI with the neonatal complications. Gonorrhea Blindness, conjunctivitis, pharyngitis, arthritis, and in rare cases, life-threatening neonatal sepsis Match the STI with the neonatal complications. HSV Lesions that are localized to the skin, eyes, or mouth. Match the STI with the neonatal complications. Trichomoniasis Neonatal complications are typically limited to the consequences of prematurity and/or low birth weight. Vaccines that are considered safe during pregnancy include Influenza, T-Dap, and COVID-19. Cami, a G1P0 at 26 weeks gestation, presents to the OB triage with complaints of fever, chills, flank pain and tenderness, urinary frequency or urgency, hematuria, and dysuria. Based on your training, what do you think she might have? Pyelonephritis When is it appropriate to start a sepsis protocol? Oral temp <36 or >38 HR >110 BPM for 15 minutes RR >24 for 15 minutes WBC count > 15000 or <4000 Match the category of intraamniotic infection (IAI) to the definition: Isolated maternal fever A single oral temperature of 102.2⁰F (39⁰C) or greater, or an oral temperature of 100.4-102.02⁰F (38-38.9⁰C) that continues when the temperature is check every 30 minutes Match the category of intraamniotic infection (IAI) to the definition: suspected IAI Based on clinical findings which include maternal intrapartum fever and one or more of the following: maternal leukocytosis, purulent cervical discharge, or fetal tachycardia Match the category of intraamniotic infection (IAI) to the definition: confirmed IAI Based on a positive amniotic fluid test result or placental pathology that indicates the presence of placental infection or inflammation Andrea, a 25 year old G1P0 at 39 5/7 weeks gestation was admitted at 1020 for spontaneous rupture of membranes. Andrea stated that she thinks her "water broke" around 2030 the night before. Her cervical examination at that time was 3/80/0 with greenish fluid noted on the exam glove. Andrea's prenatal record indicated she was positive GBS so PCN G was initiated. Andrea received an epidural for pain relieve around 1130. Andrea's cervix was examined hourly by the OB Resident. Her labor progressed as anticipated and she gave birth to a male newborn at 1630 with Apgar of 7 and 9. What factors would place Andrea at risk for an intraamniotic infection? Select the best answer. Nulliparity Premature labor Prolonged ROM Multiple cervical exams Mec-stained amniotic fluid Internal monitoring GBS STIs Maggie, a 26 year old G2P1 at 33 2/7 weeks gestation, presented to the OB triage with complaints of contractions. When placed on the fetal monitor, the tracing revealed contractions every 15-20 minutes. Maggie's cervix was closed and posterior. The provider was notified and orders were received including an order to obtain a vaginal-rectal GBS culture. Maggie was admitted for overnight observation. After receiving IV hydration, her contractions stopped and Maggie was discharged home the next day. At what gestational age would Maggie need to have a repeat GBS culture if she does not give birth? More than 5 weeks All pregnant women should receive education regarding careful handling of potentially infected items such as diapers, dirty clothing, and toys; avoiding putting a child's pacifier in her mouth; avoiding sharing food and utensils; and washing hands frequently to avoid which infection? Cytomegalovirus