# Highlight the findings or orders that require follow-up before intrapartum group B streptococcal prophylaxis is administered.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=516663&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

Highlight the findings or orders that require follow-up before intrapartum group B streptococcal prophylaxis is administered.

| Domain | Finding or order |
| --- | --- |
| Microbiology | Prenatal vaginal-rectal screen is positive for group B streptococcus |
| Labor | Regular contractions and cervical change are present |
| Allergy | Prior penicillin exposure caused anaphylaxis and hypotension |
| Susceptibility | The GBS isolate has no documented clindamycin susceptibility result |
| Prescription | Clindamycin is ordered by mouth after delivery |
| Maternal status | Temperature is 37.0 C |
| Fetal status | Baseline fetal heart rate is 140/min with moderate variability |
| History | The client received routine childhood immunizations |

## Explanation

A positive GBS screen during labor requires intrapartum prophylaxis, while prior anaphylaxis, absent clindamycin susceptibility, an oral outpatient order, and a plan to delay until delivery require immediate clarification.

## In-depth explanation

Quick answer
Verify allergy severity, route, timing, and susceptibility.

Why this is correct
Intrapartum IV antibiotics reduce neonatal GBS transmission. A high-risk penicillin allergy changes drug selection, and clindamycin use depends on susceptibility; treatment must occur during labor rather than after birth.

Easy analogy or mental picture
Choose the correct key before labor advances, and deliver it through the route that reaches the intrapartum window.

Memory hook
GBS in labor: IV prophylaxis now; severe allergy requires a susceptibility-aware alternative.

NCLEX decision rule
Highlight any finding that changes whether prophylaxis is indicated, which drug is safe, or whether the route and timing can work.

Why the other choices are wrong
A normal temperature and reassuring fetal heart rate do not correct an unsafe allergy or route plan.References
1CDC: Prevention of Perinatal Group B Streptococcal DiseaseIntrapartum IV prophylaxis, allergy assessment, and susceptibility-guided alternative selection

## Clinical scenario

GBS prophylaxis check
Confirm culture result, labor status, membrane status, allergy reaction, isolate susceptibility, IV route, drug, dose, timing, and neonatal communication.

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