Page 690 - Saunders Comprehensive Review For NCLEX-RN

are toxic and may only temporarily suppress
shedding of the virus; risk versus benefit will be
considered by the PHCP.
5. Maintain contact precautions.
E. Herpes simplex virus (“H”)
1. Herpes simplex virus affects the external genitalia,
vagina, and cervix and causes draining, painful
vesicles.
2. Acyclovir may be prescribed to treat recurrent
outbreaks during pregnancy or used as suppressive
therapy late in pregnancy to prevent an outbreak
during labor and birth.
3. Virus usually is transmitted to the fetus during birth
through the infected vagina or via an ascending
infection after rupture of the membranes.
4. No vaginal examinations are done in the presence of
active vaginal herpetic lesions.
5. Herpes can cause death or severe neurological
impairment in the newborn.
6. Delivery of the fetus is usually by cesarean section if
active lesions are present in the vagina; delivery may
be performed vaginally if the lesions are in the anal,
perineal, or inner thigh area (strict precautions are
necessary to protect the fetus during delivery).
7. Maintain contact precautions.
F. Group B Streptococcus (GBS) (may be included as an “O” under
TORCH complex)
1. GBS is a leading cause of life-threatening perinatal
infections.
2. The gram-positive bacterium colonizes the rectum,
vagina, cervix, and urethra of pregnant and
nonpregnant women.
3. Meningitis, fasciitis, and intra-abdominal abscess can
occur in the pregnant client if she is infected at the
time of birth.
4. Transmission occurs during vaginal delivery.
5. Early-onset newborn GBS occurs within the first week
after birth, usually within 48 hours, and can include
infections such as sepsis, pneumonia, or meningitis;
permanent neurological disability can result.
6. Diagnosis of the mother is done via vaginal and rectal
cultures at 35 to 37 weeks of gestation.
7. Antibiotics may be prescribed for the mother during
labor and birth; IV antibiotics may be prescribed for
infected infants.
8. Maintain contact precautions.
XVII. Multiple Gestation
A. Description

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