Maternity Nursing: Antepartum Q 6
A prenatal nurse is providing instructions to a group of pregnant clients regarding measures to prevent toxoplasmosis. Which statement if made by one of the clients indicates a need for further instructions?
A. “I need to cook meat thoroughly.”
B. “I need to avoid touching mucous membranes of the mouth or eyes while handling raw meat.”
C. “I need to drink unpasteurized milk only.”
D. “I need to avoid contact with materials that are possibly contaminated with cat feces.”
Correct Answer: C. “I need to drink unpasteurized milk only.”
All pregnant women should be advised to do the following to prevent the development of toxoplasmosis. Everyone, including immunocompetent patients, should be educated about toxoplasmosis risk factors and ways to minimize the risks. Preventing toxoplasmosis is particularly important in seronegative immunocompromised patients and in pregnant women.
Option A: Avoid eating raw meat, unpasteurized milk, and uncooked eggs, oysters, clams, and mussels. Rarely, infection by tachyzoites occurs from ingestion of unpasteurized milk or by direct entry into the bloodstream through a blood transfusion or laboratory accident. Transmission can also occur via ingestion of tissue cysts (bradyzoites) in undercooked or uncooked meat or through transplantation of an organ that contains tissue cysts. (Slaughterhouse workers and butchers may be at increased risk of infection.) In Europe and the United States, pork is the major source of T gondii infection in humans.
Option B: Women should be instructed to cook meats thoroughly, avoid touching mucous membranes and eyes while handling raw meat; thoroughly wash all kitchen surfaces that come into contact with uncooked meat, wash the hands thoroughly after handling raw meat; avoid uncooked eggs and unpasteurized milk; wash fruits and vegetables before consumption.
Option D: Avoid contact with materials that possibly are contaminated with cat feces, such as cat litter boxes, sandboxes, and garden soil. T gondii oocysts are ingested in material contaminated by feces from infected cats. Oocysts may also be transported to food by flies and cockroaches. When T gondii is ingested, bradyzoites are released from cysts or sporozoites are released from oocysts, and the organisms enter gastrointestinal cells. Host cell receptors consisting of laminin, lectin, and SAG1 are involved in T gondii tachyzoite attachment and penetration. Tachyzoites multiply, rupture cells, and infect contiguous cells. They are transported via the lymphatics and are disseminated hematogenously throughout the tissues.