A client at 32 weeks gestation has been diagnosed with syphilis. The client expresses to the nurse her belief that antibiotic therapy is harmful and refuses treatment. What is the nurse's appropriate response at this time?

Question

A client at 32 weeks gestation has been diagnosed with syphilis.  The client expresses to the nurse her belief that antibiotic therapy is harmful and refuses treatment.  What is the nurse's appropriate response at this time?

Quizplus · Accepted Answer

11ecbb05_ca50_3f66_b433_fb2bd4c77a89_MD0009_00 Nurses have an ethical responsibility to respect the pregnant client's authority to make decisions for herself and on behalf of her fetus, authority known as the principle of autonomy. A client's autonomy and right to make decisions do not change during pregnancy. The nurse should assist the client by providing education about the need for treatment and the consequences of refusing treatment for herself and the fetus, which ensures that the client's refusal of treatment is an informed decision (Option A). Syphilis is a sexually transmitted infection that crosses the placenta. Refusing treatment for syphilis may cause fetal harm or death. The only adequate treatment available during pregnancy is an IM penicillin injection. Treatment should resolve the maternal infection and prevent or successfully treat fetal infection. (Option B) Rather than elevating the rights of the fetus or using coercion, the nurse should respect the client's decision and counsel the client on the need for treatment. (Option C) The nurse should respect a client's right to refuse treatment but must inform the client that no treatment alternatives exist other than antibiotics. (Option D) A Jarisch-Herxheimer reaction (ie, fever, aches, rash, preterm labor) is a concern only for clients who receive penicillin treatment for syphilis and is not appropriate for discussion at this time. Educational objective: During pregnancy, the client retains the right to refuse care for herself and on behalf of the fetus. The nurse is responsible for ensuring that the client's refusal is an informed decision by educating the client on the consequences of refusing treatment.

A Client at 32 Weeks Gestation Has Been Diagnosed with Syphilis