Page 681 - Saunders Comprehensive Review For NCLEX-RN

4. Administer analgesics as prescribed.
5. Monitor intake and output.
6. Encourage fluids and voiding; prepare for urinary
catheterization if the client is unable to void.
7. Administer blood replacements as prescribed.
8. Monitor for signs of infection, such as increased
temperature, pulse rate, and white blood cell count.
9. Administer antibiotics as prescribed; infection is
common after hematoma formation.
10. Prepare for incision and evacuation of the hematoma if
necessary.

XI. Human Immunodeficiency Virus (HIV) and Acquired

Immunodeficiency Syndrome (AIDS)
A. Description
1. HIV is the causative agent of AIDS.
2. Women infected with HIV may first show signs and
symptoms at the time of pregnancy or possibly
develop life-threatening infections because normal
pregnancy involves some suppression of the maternal
immune system.
3. Repeated exposure to the virus during pregnancy
through unsafe sex practices or intravenous (IV) drug
use can increase the risk of transmission to the fetus.
4. Three-drug combination HAART (highly active
antiretroviral therapy) treatment, which is monitored
by an infectious disease specialist, is recommended to
reduce mother-to-child transmission (MTCT).
Zidovudine is recommended for the prevention of
MTCT and is administered based on the following
recommendations:
a. Antepartum: Orally beginning after 12
weeks of gestation, maternal HAART
is given to reduce the viral load to
undetectable.
b. Intrapartum: Intravenously during
labor, zidovudine is given 1 hour
before a vaginal birth and 3 hours
before a cesarean section if the HIV
RNA is greater than or equal to 400
copies/mL or unknown. Of note, this
may not be required if the HIV RNA is
less than 400 copies/mL but is given at
the discretion of the provider. A
vaginal birth is acceptable if the viral
load is less than 1000 copies/mL;
otherwise, a cesarean section is
recommended.

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