A pregnant client at 39 weeks arrives in active labor with a history of herpes simplex virus (HSV) and visible perineal lesions. What should be the nurse's initial action?

A pregnant client at 39 weeks arrives in active labor with a history of herpes simplex virus (HSV) and visible perineal lesions. What should be the nurse's initial action?

• A. Perform an abdominal scrub on the client.
• B. Prepare the delivery room for a vaginal delivery.
• C. Explain to the client why a cesarean delivery is necessary.
• D. Call the primary health care provider to obtain a prescription for an antiviral medication.

Answer: (C)

Active genital herpes lesions at the onset of labor significantly raise the risk of transmitting herpes to the newborn during vaginal birth. The safest approach to protect the infant is a cesarean delivery when lesions are present at labor. The nurse’s initial action is to explain to the client that a cesarean will be performed to reduce transmission risk and to begin coordinating with the provider and preparing for surgical delivery. Antiviral therapy during labor isn’t a substitute for cesarean when lesions are active, though it may be used as part of overall management if appropriate.

Active genital herpes lesions at the onset of labor significantly raise the risk of transmitting herpes to the newborn during vaginal birth. The safest approach to protect the infant is a cesarean delivery when lesions are present at labor. The nurse’s initial action is to explain to the client that a cesarean will be performed to reduce transmission risk and to begin coordinating with the provider and preparing for surgical delivery. Antiviral therapy during labor isn’t a substitute for cesarean when lesions are active, though it may be used as part of overall management if appropriate.