The nurse has received an order to rupture a patient's membranes artificially. Which finding in the patient's history would lead the nurse to question the order?
1. Group B strep negative yesterday
2. HbsAg negative at 28 weeks
3. HIV-positive X 3 years
4. History of genital herpes
3
Rationale 1: Artificial rupture of the membranes increases the incidence of chorioamnionitis. Group B strep negative findings yesterday decrease the risk of infection. Artificial rupture of the membranes is appropriate for this patient.
Rationale 2: Artificial rupture of the membranes increases the incidence of perinatal transmission of hepatitis B. This patient is negative for hepatitis B; therefore, artificial rupture of the membranes is appropriate for this patient.
Rationale 3: Artificial rupture of the membranes increases the incidence of perinatal transmission of HIV, and should not be undertaken in HIV/AIDS-positive women.
Rationale 4: A history of genital herpes does not indicate that the patient is currently experiencing an outbreak. Artificial rupture of the membranes is appropriate for this patient.
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