A 21-year-old woman, gravida 1, para 0, at 39 weeks' gestation comes to the physician for a prenatal visit. She has some mild edema and tiredness but generally feels well. She recently had a nephew visiting for 1 week who became ill and was diagnosed with the chickenpox. She has no history of chickenpox and is not vaccinated against the varicella zoster virus. Current medications include folic acid supplements and a prenatal vitamin. Her temperature is 37°C (98.6°F), pulse is 82/min, respirations are 15/min, and blood pressure is 116/64 mm Hg. Pelvic examination shows a uterus consistent in size with 39 weeks' gestation. IgG antibody titers for varicella zoster virus are negative. Which of the following is the most appropriate next step in management?
AReassurance
BSerial ultrasounds
CVaricella vaccine
DVaricella zoster immune globulin
EGanciclovir therapy
A 23-year-old woman presents to her physician requesting the chickenpox vaccine. She is also complaining of nausea, malaise, and moderate weight gain. She developed these symptoms gradually over the past 2 weeks. She reports no respiratory or cardiovascular disorders. Her last menstruation was about 6 weeks ago. She has one sexual partner and uses a natural planning method for contraception. Her vital signs include: blood pressure 110/70 mm Hg, heart rate 92/min, respiratory rate 14/min, and temperature 37.2℃ (99℉). The physical examination shows non-painful breast engorgement and nipple hyperpigmentation. There is no neck enlargement and no palpable nodules in the thyroid gland. The urine beta-hCG is positive. What is the proper recommendation regarding chickenpox vaccination in this patient?
AConfirm pregnancy with serum beta-hCG and if positive delay administration of the vaccine until the third trimester.
BPerform varicella viral load and schedule the vaccine based on these results.
CConfirm pregnancy with serum beta-hCG and if positive, postpone administration of the vaccine until after completion of the pregnancy.
DSchedule the vaccination.
EConfirm pregnancy with serum beta-hCG and if positive, schedule the patient for pregnancy termination.
A 40-year-old pregnant woman, G4 P3, visits your office at week 30 of gestation. She is very excited about her pregnancy and wants to be the healthiest she can be in preparation for labor and for her baby. What vaccination should she receive at this visit?
AMeasles, mumps, and rubella (MMR)
BVaricella vaccine
CHerpes zoster vaccine
DLive attenuated influenza vaccine
ETetanus, diphtheria, and acellular pertussis (Tdap)
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