Page 650 - Saunders Comprehensive Review For NCLEX-RN

ulceration or crusting; this is done
during pregnancy and at the onset of
labor.
c. Vaginal birth may be acceptable;
cesarean birth is required if visible
lesions are present.
d. Infants who are born through an
infected vagina should be observed
carefully, and samples should be taken
for culture.
J. Human immunodeficiency virus (HIV)

1. HIV is transmitted through blood; blood products;
and other bodily fluids such as urine, semen, and
vaginal secretions; the virus is also transmitted
through exposure to infected secretions during birth
and through breast milk.
2. Repeated exposure to the virus during pregnancy
through unsafe sex practices or intravenous drug use
can increase the risk of transmission to the fetus.
3. Perinatal administration of zidovudine may be
recommended to decrease the risk of transmission of
HIV from mother to fetus.
K. Substance abuse

1. Substance abuse threatens normal fetal growth and
successful term completion of the pregnancy.
2. Substance abuse places the pregnancy at risk for fetal
growth restriction, abruptio placentae, and fetal
bradycardia.
3. Many substances cross the placenta and can be
teratogenic (drugs, tobacco, alcohol, medications,
certain foods such as raw fish); no over-the-counter
medications should be taken unless prescribed by the
PHCP.
4. Smoking (tobacco) can result in low birth weight, a
higher incidence of birth defects, and stillbirths.
5. Physical signs of drug abuse may include dilated or
contracted pupils, fatigue, track (needle) marks, skin
abscesses, inflamed nasal mucosa, and inappropriate
behavior by the mother.
6. Consumption of alcohol during pregnancy may lead
to fetal alcohol syndrome and can cause jitteriness,
physical abnormalities, congenital anomalies, and
growth deficits in the newborn.
L. Viral hepatitis (see Chapters 22, 33, and 48 for information
regarding hepatitis B infection)

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