The nurse explains to a newly diagnosed pregnant woman at 10 ...

[Kthamas]

The nurse explains to a newly diagnosed pregnant woman at 10 weeks' gestation that her rubella titer indicates that she is not immune.
 
  Which of the following should the nurse teach the patient? (Select all that apply.)
  A.
  Avoid contact with all children until after you have given birth.
  B.
  Be retested in 3 months and obtain the vaccination if not immune.
  C.
  Do not become pregnant for 4 weeks after you receive the vaccination.
  D.
  Receive the rubella vaccine during the postpartum period.
  E.
  Seek medical care immediately for fever, runny nose, or rash.

Question 2

The nurse provides increased support to a woman during her first prenatal visit for her current pregnancy. The patient's first pregnancy ended in a miscarriage. The nurse understands that the reasons the patient may be ambivalent about this baby include w
 
  A.
  Awareness of a new 24-hour responsibility
  B.
  Needs related to a second pregnancy
  C.
  Potential role/relationship changes
  D.
  Previous perinatal loss
  E.
  Unresolved grief and mourning

[canderson530]

Answer to Question 1

ANS: C, D
Rubella (German measles) is one of the most commonly recognized viral infections known to cause congenital problems. If a woman contracts rubella during the first 12 weeks of pregnancy, the fetus has a 90 chance of being adversely affected. A maternity patient who is not immune to rubella should be offered the rubella immunization following childbirth, ideally prior to hospital discharge. She should also be taught to avoid becoming pregnant for at least 4 weeks after the immunization. The patient should report signs or symptoms of rubella during pregnancy to her health-care provider, but she does not need to seek medical care immediately. Avoiding contact with all children is unreasonable. There is no reason to be retested in 3 months, because she cannot receive the vaccination until after she has given birth.

Answer to Question 2

ANS: A, C, D, E
Ambivalence is a normal response to pregnancy that is in part related to the anticipated role changes that will occur. The loss of a previous pregnancy brings many emotions to a subsequent pregnancy. This patient should be counseled for her previous loss, unresolved grief and mourning, potential role changes, and new responsibilities as a parent if she carries this pregnancy to term.