Answer Happy

A 30-year-old woman who has been pregnant 2 times in the past but never got to delivery and is 12 weeks pregnant now comes to you for advice. She is your neighbor and heard you are studying to be a nurse. She tells you that at her last visit to the doctor he had done some tests and told her that she was not immune to Rubella. She wants to protect her fetus and wants to know if a rubella vaccine is good for her. With your knowledge of AP and knowing that the rubella vaccine is a live vaccine; you recommend which of the following? Ⓒ That she should wait to take the vaccine after 24 weeks of pregnancy O That she goes for immediate vaccination today That she gets the vaccine during her next visit to her doctor in a month O That she should not take the vaccine until after she delivers her baby. O That she thinks of interrupting the pregnancy as the baby will be affected already.
A 24-year-old pregnant female presents at 12 weeks with a history of Hypothyroidism. She is currently on thyroid medications and have been even before she got pregnant. She is visiting the clinic today because she is worried that her illness might affect her baby in the uterus. She wants advice about changes in her thyroid medications. You as a nurse know that proteins increase in pregnancy, TSH levels also increase and bound portion of T4, T3 increases too. Using your physiology knowledge, what would you not be surprised to hear the doctor say? As the pregnancy progresses, she will likely have to decrease her thyroid medication dose. O She will stop to take her thyroid medication as her pregnancy progresses as she will not need them anymore until after delivery The dosage of her thyroid medication will likely have to be increased as the pregnancy progresses O She most likely will not need to alter her thyroid medication doses in any way. O There will be no need to increase her thyroid medicine dose until after baby is born.
A 25-year-old female friend of yours, who is contemplating conceiving with her husband, comes to see you after her prenatal screening physical. She and her husband are both monogamous. She is a known hypertensive and is currently being treated with Lisinopril, a teratogen, for her essential HTN. She also takes a daily prenatal vitamin per the recommendation of her sister. Her family history is not significant. And she reports that the doctor told her the physical exam was unremarkable. She wants to know what you would advise her on getting pregnant, with her HTN and taking the Lisinopril. What do you think her doctor would do next? O He would stop her lisinopril and change it to an alternative medication for hypertension. O He would stop her lisinopril and monitor her BP monthly O He would recommend against conceiving O He would not change her medications O He would increase her lisinopril dose to 40 mg and check her renal function in 2 weeks