One day after giving birth vaginally, a patient develops painful vesicular lesions on her perineum and vulva. She is diagnosed with a primary herpes simplex 2 infection. The expected care for her neonate includes:
1. Meticulous hand washing and antibiotic eye ointment administration.
2. Intravenous acyclovir (Zovirax) and contact precautions.
3. Cultures of blood and CSF and serial chest x-rays every 12 hours.
4. Parental rooming-in and four intramuscular injections of penicillin.
2
Rationale 1: Although meticulous hand washing by staff and parents is important, antibiotic eye ointment is used for conjunctivitis of gonorrhea or chlamydia.
Rationale 2: These are appropriate measures for an infant at risk for developing herpes simplex 2 infection.
Rationale 3: These cultures are appropriate, but chest x-rays are not indicated. Chest x-rays are obtained if the neonate is thought to have group B strep pneumonia.
Rationale 4: Parental rooming-in is encouraged, but penicillin does not treat viral illness.
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