A nurse is teaching a client who is pregnant and has genital herpes simplex virus (HSV). Which of the following statements should the nurse include in the teaching?
A.
“You should take 600 milligrams of ibuprofen every 8 hours for discomfort during an outbreak.”
B.
“You will need to have a cesarean birth if there are any visible lesions.”
C.
“Your baby’s cord blood will be tested to determine if she has contracted HSV.”
D.
“You can apply a cortisone cream to the lesions twice each day.” .
The Correct Answer and Explanation is:
The correct answer is B: “You will need to have a cesarean birth if there are any visible lesions.”
Explanation:
Genital herpes simplex virus (HSV) presents significant considerations for pregnant women, particularly concerning the mode of delivery. HSV can cause severe complications for the newborn if transmitted during delivery, so managing outbreaks and delivery methods becomes critical.
- Cesarean Delivery: The most crucial point in managing HSV during pregnancy is to prevent neonatal herpes, a severe and potentially life-threatening condition. If a pregnant woman has active genital herpes (e.g., visible lesions) at the time of delivery, a cesarean section (C-section) is usually recommended. This is because HSV can be transmitted to the baby during a vaginal delivery if the virus is present in the birth canal. C-sections reduce the risk of transmission by avoiding direct contact with the infected genital area.
- Medication and Management: While medication is essential for managing herpes outbreaks, ibuprofen (Option A) is not the primary treatment for HSV-related discomfort. Antiviral medications such as acyclovir, valacyclovir, or famciclovir are typically used to manage outbreaks and reduce the risk of transmission to the baby. Ibuprofen may help with general discomfort, but it does not address the underlying viral infection.
- Testing for HSV in Newborns: Testing the baby’s cord blood (Option C) is not a standard practice for diagnosing neonatal herpes. Instead, if a baby is suspected of having HSV, testing would usually involve direct examination and possibly swabs of suspected lesions or body fluids, not cord blood.
- Topical Treatments: Cortisone creams (Option D) are not recommended for treating HSV lesions. Antiviral medications are preferred for managing HSV outbreaks. Cortisone creams might exacerbate the condition or be ineffective for viral infections.
In summary, the key teaching point for a pregnant client with genital HSV is the importance of planning for a cesarean delivery if there are any visible lesions to prevent transmission of the virus to the newborn.