Understanding infections in pregnancy is crucial for nursing students preparing for the NCLEX exam due to several reasons:
Maternal Health: Infections during pregnancy can have serious consequences for the mother's health. Some infections, if left untreated, can lead to complications such as sepsis, preterm labor, and even maternal death.
Fetal Health: Infections can also significantly impact the developing fetus. Certain infections can lead to birth defects, intrauterine growth restriction, premature birth, or fetal demise.
Neonatal Health: Infections acquired during pregnancy can be transmitted to the newborn during childbirth or through breastfeeding. This can lead to neonatal infections that require medical intervention.
Recognition and Diagnosis: Nursing students need to recognize the signs and symptoms of various infections in pregnant individuals to ensure timely diagnosis and treatment. This knowledge is vital for effective nursing care.
Management and Treatment: Understanding the appropriate treatment and management of infections during pregnancy is essential. Some infections may require medications that are safe for both the mother and the developing fetus.
NCLEX Preparation: The NCLEX exam may include questions about infections during pregnancy, their assessment, management, and potential complications. A strong understanding of this topic is essential for confidently answering these questions.
Infections during pregnancy are a critical concern that impacts the health and well-being of both the mother and the fetus. Nursing students who grasp the significance of this topic are better prepared to provide safe and informed care to pregnant individuals and their newborns, aligning with the principles of patient-centered nursing practice.
1. Specific infections during pregnancy are more concerning due potential transmission to the fetus (via placenta or during delivery), which can have detrimental effects on the newborn
2. TORCH
a. T - Toxoplasmosis
b. O - Other
i. ie: Group B strep (GBS), HIV, Syphilis
c. R - Rubella
d. C - Cytomegalovirus
e. H - Herpes simplex
1. Toxoplasmosis
a. Parasitic disease transmitted to mother while handling cat litter, undercooked or raw meat, or gardening; transmitted to fetus via the placenta
b. Mother is typically asymptomatic but may have a rash or flu-like symptoms for anywhere from a few weeks to months
c. Fetal death, spontaneous abortion, and neuro complications may result
d. Educate the mother to never change cat litter
2. Other
a. Group-B Strep
i. All women screened for this during the prenatal period by a vaginal swab 35-37 weeks
ii. All women have the bacteria but the results will depend on the amount that is colonized
iii. Prophylactic antibiotics (penicillin or ampicillin) given during labor to women who screen positive
iv. Main cause of bacterial infections in newborns, which causes sepsis
b. HIV
i. Delivery by c/s to limit transmission
ii. Infants are given antiretrovirals
c. Syphilis
i. Woman given penicillin and fetus receives penicillin after delivery
3. Rubella
a. Transmitted via placenta
b. Most dangerous/serious if mother acquires this infection in 1st trimester
c. Brain damage, hearing loss, miscarriage, stillbirth, and various congenital defects may result
d. Assess the mother’s immunity by drawing titer. If her titer is non-immune, then vaccinate immediately after delivery because it is a live vaccine.
i. The vaccine will protect for future pregnancies
4. Cytomegalovirus (CMV)
a. A very common, asymptomatic virus transmitted through bodily fluids
b. Transmitted via placenta or during delivery and can cause intrauterine growth restriction, seizures, blindness, hepatomegaly, splenomegaly, jaundice, hearing loss, microcephaly, and/or death
5. Herpes Simplex
a. Transmitted during birth, if active lesions present. A c-section should be done if active lesion to prevent transmission
b. Acyclovir may be given around 36 weeks to prevent an outbreak during labor and delivery
c. Serious neonatal complications (death,neurologic issues, etc.)
Patient: Kelly
Assessment:
Identify signs and symptoms of infection, such as fever, chills, increased heart rate, fatigue, and localized pain.
Obtain detailed medical history, including any recent illnesses or exposures to infectious agents.
Assess for risk factors for infection, such as immunocompromised status, preexisting medical conditions, and travel history.
Monitor laboratory values, such as complete blood count (CBC) and cultures, to detect signs of infection.
Nursing Diagnoses:
Goals:
Patient will receive timely and appropriate treatment for the infection.
Patient will report reduced anxiety related to infection and its impact on pregnancy.
Patient will demonstrate understanding of preventive measures and management strategies for infections in pregnancy.
Interventions:
1. Infection Management:
Collaborate with the healthcare provider to initiate appropriate antimicrobial therapy based on culture and sensitivity results.
Monitor the patient's response to treatment and report any adverse reactions promptly.
Educate the patient about the importance of completing the full course of antibiotics as prescribed.
2. Symptom Relief:
Administer prescribed antipyretics and analgesics to alleviate fever, pain, and discomfort.
Ensure the patient is well-hydrated and encourage rest to support recovery.
3. Patient Education:
Educate the patient about the signs and symptoms of infection, when to seek medical attention, and the importance of early intervention.
Discuss preventive measures, including proper hand hygiene, avoiding sick individuals, and maintaining a healthy lifestyle.
4. Fetal Monitoring:
Collaborate with the obstetric team to monitor fetal well-being using nonstress tests or other appropriate methods.
Assess for signs of fetal distress and promptly communicate any concerns to the healthcare provider.
5. Follow-Up Care:
Schedule follow-up appointments to monitor the patient's progress and response to treatment.
Educate the patient about signs of recurrent infection and the need for continued vigilance.
Evaluation:
Patient receives appropriate treatment for the infection, with resolution of signs and symptoms.
Patient reports reduced anxiety and demonstrates improved coping with the situation.
Patient demonstrates understanding of preventive measures and management strategies for infections in pregnancy.
Discharge Planning:
Provide written instructions about completing the prescribed course of antibiotics and monitoring for signs of recurrent infection.
Encourage the patient to maintain communication with the healthcare provider and promptly report any changes in symptoms or concerns.
This Infections (in Pregnancy) review provides essential knowledge for confidently approaching the NCLEX. Understanding its prevention, management, and interventions empowers nurses to provide adequate care and save lives.
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