Page 695 - Saunders Comprehensive Review For NCLEX-RN

c. The infection may cause abortion or
premature labor and is passed to the
fetus after the fourth month of
pregnancy as congenital syphilis.
2. Assessment (Box 22-7)
3. Interventions
a. A serum test (Venereal Disease
Research Laboratory or rapid plasma
reagin) for syphilis is done on the first
prenatal visit; prepare to repeat the test
at 36 weeks of gestation because the
disease may be acquired after the
initial visit.
b. If the test result is positive, treatment
with an antibiotic may be necessary.
c. Sonographic evaluation is necessary to
assess for signs of placental syphilis.
d. Instruct the client that treatment of her
partner is necessary if infection is
present, and intercourse should be
avoided until treatment is instituted.
e. Complications include transmission to
fetus (100% in primary and secondary
stages), congenital anomalies,
deafness, neurological impairment
(mortality rate is 50%).
f. Those with syphilis should also be
tested for HIV.
C. Gonorrhea
1. Description
a. Gonorrhea is an infection caused by
Neisseria gonorrhoeae, which causes
inflammation of the mucous
membranes of the genital and urinary
tracts.
b. Transmission of the organism is by
sexual intercourse.
c. Infection may be transmitted to the
newborn’s eyes during delivery,
causing blindness (ophthalmia
neonatorum).
2. Assessment: Usually asymptomatic; vaginal discharge,
urinary frequency, and lower abdominal pain
possible
3. Interventions
a. Testing is done during the initial
prenatal examination to screen for
gonorrhea; the screening may be

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