A pregnant woman admitted to the labor and birth suite undergoes rapid HIV testing and is found to be HIV-positive. Which of the following would the nurse expect to include when developing a plan of care for this women? (Select all that apply.)

Question

A) Administration of penicillin G at the onset of labor
B) Avoidance of scalp electrodes for fetal monitoring
C) Refraining from obtaining fetal scalp blood for pH testing
D) Administering zidovudine at the onset of labor.
E) Electing for the use of forceps-assisted delivery

Answer 1

B, C, D
Feedback:
To reduce perinatal transmission, HIV-positive women are given zidovudine (ZDV) (2 mg/kg IV over an hour, and then a maintenance infusion of 1 mg/kg per hour until birth) or a single 200-mg oral dose of nevirapine at the onset of labor; the newborn is given ZDV orally (2 mg/kg body weight every 6 hours) and should be continued for 6 weeks (Gardner, Carter, Enzman-Hines, & Hernandez, 2011). To further reduce the risk of perinatal transmission, ACOG and the U.S. Public Health Service recommend that HIV-infected women with plasma viral loads of more than 1,000 copies per milliliter be counseled regarding the benefits of elective cesarean birth (Reshi & Lone, 2010). Additional interventions to reduce the transmission risk would include avoiding use of scalp electrode for fetal monitoring or doing a scalp blood sampling for fetal pH, delaying amniotomy, encouraging formula feeding after birth, and avoiding invasive procedures such as forceps or vacuum-assisted devices.