A nurse is reinforcing teaching with a client who is at 38 weeks of gestation and has a positive group B streptococcus B-hemolytic screening.
Which of the following medications should the nurse discuss as the prophylaxis treatment during labor for this client?
Penicillin.
Cefazolin.
Erythromycin.
Vancomycin.
The Correct Answer is A
Choice A rationale
Penicillin is the recommended prophylactic treatment for a client at 38 weeks of gestation with a positive group B streptococcus B-hemolytic screening. It is highly effective in preventing the transmission of group B strep from mother to baby during labor and delivery. Administering Penicillin reduces the risk of neonatal sepsis, pneumonia, and meningitis caused by group B strep.
Choice B rationale
Cefazolin is an alternative antibiotic for clients allergic to penicillin. It is less preferred compared to penicillin due to its broader spectrum of activity and potential for resistance. Cefazolin can be used if the client has a non-severe penicillin allergy.
Choice C rationale
Erythromycin is not recommended for group B strep prophylaxis during labor due to its lower efficacy compared to penicillin and cefazolin. It is less effective in preventing neonatal group B strep infections and is used less frequently.
Choice D rationale
Vancomycin is used for clients with a severe penicillin allergy or for those with resistant strains of group B strep. It is a last-resort antibiotic due to its potent effect and potential side effects. It is only used when absolutely necessary.
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Correct Answer is B
Explanation
Choice A rationale
Increasing the frequency of feedings from the affected nipple may aggravate nipple soreness, as it doesn't allow the area to recover and heal properly between feedings.
Choice B rationale
Exposing the affected nipple to the air between feedings can help it to dry and heal, reducing soreness. Air exposure can help prevent bacterial growth and keep the nipple area healthy.
Choice C rationale
Applying vitamin E oil to the affected nipple before each feeding is not recommended as it can make the nipple slippery, affecting the baby's latch, and it might not be safe if ingested by the baby.
Choice D rationale
Washing the affected nipple with soap and water before each feeding can strip the natural oils from the skin, leading to further dryness and irritation, which can increase soreness.
Correct Answer is C
Explanation
Choice A rationale
The newborn's legs flexing at the knees and hips when pressure is applied to the soles indicates the stepping reflex, an expected response.
Choice B rationale
Newborns do not typically keep their eyes closed when tapped on the forehead; this is not an expected reflex response.
Choice C rationale
The palmar grasp reflex, where the newborn's fingers curl around the nurse's finger, is an expected and normal finding in newborns, indicating healthy neurological function.
Choice D rationale
The rooting reflex, where the newborn turns their head when their cheek is touched, is expected and demonstrates feeding readiness and normal neural development. .