The nurse has received an order to rupture the membranes of a ...

[jrubin]

The nurse has received an order to rupture the membranes of a client artificially. Which finding in the client's history would lead the nurse to question the order?
 
  1. Group B strep negative yesterday
  2. HbsAg negative at 28 weeks
  3. HIV-positive X 3 years
  4. History of genital herpes

Question 2

A Navajo client who is 36 weeks pregnant meets with the tribe's medicine man as well as her physician. The nurse understands this to mean that the client:
 
  1. Is seeking spiritual direction.
  2. Does not trust her physician.
  3. Will not adapt to mothering well.
  4. Is experiencing complications of pregnancy.

[allisonblackmore]

Answer to Question 1

3
Rationale:
1. Artificial rupture of the membranes increases the incidence of chorioamnionitis. Group B strep negative findings yesterday decrease the risk of infection. This client is appropriate for artificial rupture of membranes.
2. Artificial rupture of the membranes increases the incidence of perinatal transmission of hepatitis B. This client is negative for hepatitis B; therefore, this client is appropriate for artificial rupture of membranes.
3. Artificial rupture of the membranes increases the incidence of perinatal transmission of HIV, and should not be undertaken in HIV/AIDSpositive women.
4. A history of genital herpes does not indicate that the client is currently experiencing an outbreak. This client is appropriate for artificial rupture of membranes.

Answer to Question 2

1
Rationale:
1. As a result of the introspection that develops, pregnant women often will seek spiritual guidance from their preferred spiritual leader. The nurse has a professional responsibility to promote clients' spiritual well-being. Understanding the belief systems of the client population will facilitate intercultural communication, and will help the nurse provide appropriate information using appropriate teaching methods.
2. This does not indicate mistrust of the provider.
3. This does not indicate mistrust of parenting ability.
4. This does not indicate any type of pathology or complications.

[jrubin]

Thanks for the timely response, appreciate it

[bitingbit]

TYSM