Chapter 8 - Infections Flashcards
(50 cards)
Explain HIV; what does it attack and cause?
HIV is a retrovirus that attacks and causes destruction of T lymphocytes. It causes immunosuppression in a client.
How is HIV transmitted from mother to neonate?
Perinatally through the placenta and postnatally through the breast milk.
When is HIV testing recommended? When should rapid HIV testing be done?
Third trimester for clients who are at greater risk.
Rapid HIV testing should be done if a client is in labor and HIV status is unknown.
What procedures/tools should be avoided for HIV mom’s and why?
Amniocentesis and episiotomy. d/t risk of maternal blood exposure
Forceps, internal fetal monitors, and vacuum extractions d/t risk of fetal bleeding
Administration of injections and blood testing should be avoided till……..
First bath is given to the newborn
Risk factors for HIV
- IV drug use
- Multiple sex partners
- Maternal hx of STI’s
- Blood transfusion (rare)
- Men who have sex with men
Expected findings for HIV
- Fatigue and influenza like findings
- Fever
- Diarrhea and weight loss
- Lymphadenopathy and rash
- Anemia
How is HIV tested and confirmed?
Begins with an antibody screening test (enzyme immunoassay).
Confirmed by Western blot test or immunofluorescence assay
What immunizations are encouraged? Scheduled cesarean births should be planned if..?
Hep B, pneumococcal, influenza type B, viral influenza
Scheduled c-section at 38 weeks for maternal viral load of more than 1,000 copies/mL
Medication for HIV and considerations for administration to mom and infant
- Retrovir (antiretroviral agent)
- Administer at 14 weeks of gestation, throughout pregnancy, and before the onset or labor or cesarean birth
- Administer to infant at delivery and for 6 weeks following birth
What are TORCH infections?
Toxoplasmosis, other infections, rubella, cytomegalovirus, and herpes simplex virus.
They are a group of infections that can negatively impact a pregnancy by crossing the placenta and causing teratogenic effects
Risk factors for TORCH infections?
- Toxoplasmosis: consumption of raw or undercooked meat or handling cat feces
- Other infections include Hep A and Hep B, syphilis, mumps, parvovirus B19, varicella zoster: associated w/ congenital anomalies
- Rubella: children who have rashes or neonates who are born to women with rubella during pregnancy
- Cytomegalovirus: droplet infection from person to person, virus found in semen, cervical and vaginal secretions, breast milk, placental tissue, urine, feces, and blood. Latent virus can be reactivated and cause diseas to the fetus in utero or during passage through birth canal
- Herpes simplex virus: direct contact with oral or genital lesions. Transmission to the fetus is greated during vaginal birth if mom has active lesions.
Expected findings for TORCH infections:
- Toxoplasmosis: influenza like findings (malaise, fever, tender lymph nodes, muscle aches)
- Rubella: joint and muscle pain (rash, fever, can cause miscarriage)
- Cytomegalovirus: asymptomatic or mononucleosis
- HSV: painful blisters and tender lymph nodes
How is TORCH diagnosed?
HSV: obtained when women are at or near term
- Immunologic survery to identify if these infections are in the mother (fetal risks) or newborn (detection of antibodies against infections)
- Prenatal screening
Should rubella be administered to a pregnant women?
NO, it is contraindicated because rubella infection can develop.
They should avoid crowds of young children
Medications for TORCH infections
- Antibiotics
- Toxoplasmoosis: sulfonamides or a combination of pyrimethamine and sulfadiazine
What is recommended for a pregnant woman with HSV?
C-section for those who have active genital lesions or early symptoms of impending outbreak (vulvar pain and itching)
What is Group B streptococcus and how is it transmitted?
It is a bacterial infection and can be passed to a fetus during labor and delivery
Risk factors for GBS
- Age 20 or less
- African american or hispanic ethnicity
- Positive culture with pregnancy
- Prolonged rupture of membranes
- Preterm delivery
- Low birth weight
- Use of intrauterine fetal monitoring
- Intrapartum maternal fever
What lab tests are done for GBS?
Vaginal and rectal cultures are performed at 35 to 37 weeks of gestation
What medication is administered for GBS and for which clients?
- Penicillin G or ampicillin
- Bactericidal antibiotic is used to destroy the GBS
It is for clients who:
- has GBS bactteriuria during current pregnancy
- has a GBS positive screening
- unknown GBS status who’s delivery before 37 weeks
- maternal fever of 38 celsius
- rupture of membranes for 18 hours or longer
What is chlamydia? If untreated, what can occur?
- Bacterial infection caused by chlamydia trachomatis and is the most commonly reported STI
- If untreated, it can lead to pelvic inflammatory disease, which can cause infertility
Expected findings of chlamydia in males and females
Males - mucoid or watery uretheral discharge, dysuria
Females - dysuria, urinary frequency, spotting or postcoital bleedings
Lab tests for chlamydia
Male - urine culture
Female - endocervical culture
