The graduate nurse (GN) is caring for a client at 20 weeks gestation with secondary syphilis. The client reports an allergic reaction to penicillin as a child but does not know what kind of reaction occurred. When discussing the client's potential treatment plan with the precepting nurse, which statement by the GN indicates an appropriate understanding?

Question

The graduate nurse (GN) is caring for a client at 20 weeks gestation with secondary syphilis.  The client reports an allergic reaction to penicillin as a child but does not know what kind of reaction occurred.  When discussing the client's potential treatment plan with the precepting nurse, which statement by the GN indicates an appropriate understanding?

Quizplus · Accepted Answer

11ecbb05_cbfe_b313_b433_79e0626100eb_MD0009_00 Syphilis is a sexually transmitted infection that crosses the placenta and may have teratogenic effects on fetal development. All pregnant clients are screened for syphilis at the initial prenatal visit, and high-risk clients are screened again during the third trimester and labor. Maternal manifestations of syphilis may vary depending on the time of diagnosis. The only adequate prenatal treatment is IM penicillin injection (ie, benzathine penicillin G). Expected outcomes include resolution of maternal infection and prevention or treatment of fetal infection. If a pregnant client has a penicillin allergy, the nurse should anticipate penicillin desensitization so that adequate treatment can be provided (Option B). (Option A) Doxycycline, a tetracycline antibiotic, is a potential treatment alternative for nonpregnant clients with syphilis but is contraindicated in pregnancy because it can impair fetal bone mineralization and discolor permanent teeth. (Option C) Syphilis that goes untreated can result in fetal or newborn death. Although some newborns require treatment after birth, complications (eg, skeletal abnormalities, anemia, preterm birth) related to congenital syphilis can be prevented with prenatal treatment. (Option D) Many clients with primary syphilis have nonreactive serologic tests due to a delay in antibody development. However, IM penicillin therapy is appropriate for the treatment of primary, secondary, or latent syphilis. Educational objective: Syphilis is a sexually transmitted infection that crosses the placenta and may have teratogenic effects on fetal development. If a pregnant client has a penicillin allergy, penicillin desensitization is recommended to receive appropriate treatment (ie, IM benzathine penicillin G) and prevent or treat congenital syphilis.

The Graduate Nurse (GN) Is Caring for a Client at 20