A woman is 32 weeks pregnant. She is HIV-positive, but ...

[LCritchfi]

A woman is 32 weeks pregnant. She is HIV-positive, but asymptomatic. What would be important in managing her pregnancy and delivery?
 
  1. An amniocentesis at 30 and 36 weeks
  2. Weekly non-stress testing beginning at 32 weeks' gestation
  3. Application of a fetal scalp electrode as soon as her membranes rupture in labor
  4. Administration of intravenous antibiotics during labor and delivery

Question 2

A 7 pound, 14 ounce girl was born to an insulin-dependent type II diabetic mother two hours ago. The infant's blood sugar is 45. The best nursing action is:
 
  1. Recheck the blood sugar in four hours.
  2. Begin an IV of 10 dextrose.
  3. Feed the baby one ounce of formula.
  4. Document the findings in the chart.

[Jody Vaughn]

Answer to Question 1

2
Rationale:
1. All invasive procedures that would expose the uninfected infant to the HIV virus are avoided.
2. Clients who are HIV-positive are considered high-risk pregnancies. Therefore, beginning at about 32 weeks, these clients have weekly non-stress tests to assess for placental function, and an ultrasound every 23 weeks to assess for intrauterine growth retardation (IUGR).
3. All invasive procedures that would expose the uninfected infant to the HIV virus are avoided.
4. Antibiotics would be ineffective for either the mother or the infant who was HIV-positive.

Answer to Question 2

4
Rationale:
1. Infants of diabetic mothers should be fed frequently, and should have their blood sugar assessed frequently. Four hours is too long a time frame.
2. 45 is considered a normal blood sugar reading for a neonate. No IV is needed.
3. Feeding would be appropriate if the infant's blood sugar were below 40, but this infant's reading is 45.
4. A blood sugar of 45 is a normal finding; documentation is an appropriate action.

[LCritchfi]

Excellent

[mohan]

Gracias!