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Level IV OB Infections in Pregnancy Part I: TORCH
Includes toxoplasmoxix, other (Hep B), rubells, cytomegalovirus, herpes simplex virus
39
Nursing
Undergraduate 4
03/30/2013

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Term
T
O
R
C
H
Definition
toxoplasmosis
other (hep B)
rubella
cytomegalovirus (CMV)
herpes simplex virus (HSV)
Term
Qualities of TORCH infections
Definition
crosses placents
may adversely affect fetus
depends on developmental stage
Term
Toxoplasmosis transmission
Definition
ingestion of raw or partially cooked meat (lamb, pork, or venison)
contact with infected cat feces
Term
Maternal effects
Definition
flulike symptoms
swollen lymph glands
muscle aches and pains
possible asymptomatic
Term
Neonatal effects
Definition
neurological
opthalmological
cognitive
IUGR
hydrocephaly
microcephaly
Term
Therapeutic management
Definition
wash hands and wear gloves when handling soil
cook meat thoroughly
keep cat inside and do not change litter box
wash all kitchen surfaces that come into contact with uncooked meat
avoid uncooked aggs and unpasteurized milk
wash fruits and vegetables
Term
Medical management
Definition
sulfonamides
spiramycin
Term
transmission of mother to fetus is highest when
Definition
third trimester
Term
what severe infant complications may occur when it is transmitted during the first trimester?
Definition
chorioretinitis,
hydrocephaly
microcephaly
calcifications within cranium
Term
Other (hepatitis b) transmission
Definition
contact with blood, stool and saliva
horizontal and vertical transmission
at risk: HC workers, IV drug users, homosexuals, persons with multiple sexual partners
Term
Maternal effects
Definition
low grade vever, N, anorexia jaundice
preterm labor and delivery
cirrhosis and liver cancer
Term
Neonatal effectsq
Definition
stillbirth
90% chance of infection
Term
Therapeutic Management
Definition
hep b vaccination for prevention
hep b immune globulin if chronic maternal infection
Term
Cytomegalovirus transmission
Definition
contact with saliva, urine, feces, blood, and musous
horizontal and vertical
Term
Maternal effects
Definition
sore throat, fever body aches fatigue
most asymptomatic
Term
Neonatal effects
Definition
cns abnormalities
deafness blindness and mental retardation
Term
Therapeutic management
Definition
no effective therapy
universal precautions and hand washing
Term
what is the chance of the fetus being infected if the woman develops it during pregnancy
Definition
40-50%
Term
what is CMV the lading cause of?
Definition
hearing loss in children
Term
Herpes Simplex Virus Transmission:
Definition
saliva, horizontal, vertical
Term
Type 1 HSV
Definition
cold sores
Term
Type 2 HSV
Definition
genital sores
Term
How is it passed vertically
Definition
passage through infected birth canal
rarely transplacental
Term
What are the maternal effect?
Definition
painful leisions or cluster of blisters
rare complications
Term
Neonatal effects
Definition
infection of skin mouth and eyes
high mortality rate
mental retardation, cerebral palsy, blindness, deafness
Term
Therapeutic Management
Definition
acyclovir, famciclovir, or vidarabine during pregnancy
avoid vaginal delivery with active lesions
delivery within 4 hours after ROM and active lesion
Term
a patient has active lesions as a result of herpesvirus, what should the nurse prepare her for?
Definition
c-section
Term
a patient has active lesions as a result of herpesvirus, should electrodes be used and if not when are they appropriate to be used?
Definition
no.
when there are no active lesions
Term
can a mother with HSV breastfeed?
Definition
if there are no lesions on the breasts then yes
Term
what is the infant observed for?
Definition
temperature
instability
lethargy
poor sucking reflex
jaundice
seizures
lesions
Term
What may be prescribed to the infant who shows signs of an infection of HSV?
Definition
acyclovir therapy
Term
Rubella transmission
Definition
highly contagious
nasopharyngeal secretions and vertically
Term
Maternal effects
Definition
rash, swollen glands, low grade fever, joint pain
often asymptomatic
Term
neonatal effects
Definition
stillbirth/miscarriage
blindness, hearing loss, mental retardation
Term
Therapeutic management
Definition
prevention only protection
vaccination when not pregnant, wait 28 days after vaccination to attempt conception
Term
What should the rubella titer be to determine immunity
Definition
1:8
Term
What is the vaccination for rubella
Definition
live virus
Term
how long should a woman wait to become pregnant
Definition
4 weeks
Term
are women given the vaccine during the postpartum period if they are nonimmune
Definition
yes
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