NCLEX-PN

I.​ TORCH is an acronym encompassing: ●​ T oxoplasmosis ●​ O ther infections ●​ R ubella ●​ C ytomegalovirus ●​ H erpes

These infections are grouped under TORCH due to their ability to breach the protective placental barrier . As a result, they not only endanger the health of the pregnant woman but also pose serious risks to the growth and development of the fetus, with potential teratogenic effects. Given the severity of these threats, immunological TORCH screening is often performed to identify these infections in pregnant women. Risk factors and treatments for TORCH infections vary based on the specific infection and its severity. Toxoplasmosis can be contracted by handling contaminated feline feces or consuming undercooked meat ; rubella spreads through contact with an infected individual when the host lacks immunization ; cytomegalovirus is transmitted via bodily fluids like vaginal secretions, semen, blood, placental tissue, breast milk, and others; finally, maternal herpes simplex infections result from direct contact with infectious genital or oral lesions , and neonates are exposed to this infection during vaginal delivery if the pregnant woman has active herpes simplex lesions on the genitalia at the time of birth. J.​ Group B Streptococcus B-Hemolytic Infection Group B Streptococcus B-hemolytic infections can also be transmitted to the fetus during labor and delivery. Some risk factors associated with these infections include premature delivery, low birth weight, maternal history of these infections, premature rupture of membranes, maternal age under 20, and secondary to invasive intrauterine fetal monitoring. Intravenous amoxicillin and penicillin G are used to treat Group B Streptococcus B-hemolytic infections and sometimes for prophylaxis during pregnancy. K.​ Toxic shock syndrome caused by staphylococcus aureus or streptococcal infection can result from burns, childbirth, surgery, and trauma. Streptococcal toxic shock syndrome is generally more severe and life-threatening than staphylococcus toxic shock syndrome, often leading to systemic collapse. ●​ Signs and symptoms of toxic shock syndrome include hypotension, skin peeling on the palms, a red skin rash, high fever, altered consciousness, nausea, vomiting, and elevated nitrogen and creatinine levels. ●​ Antimicrobial drugs of choice are first-generation cephalosporins or penicillin . Vancomycin or clindamycin can be used if allergic to or sensitive to the first-line drugs. Hospitalization and close monitoring of the pregnant woman may be necessary to mitigate the high morbidity and mortality rates associated with toxic shock syndrome during pregnancy.

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