Maternity Nursing: Postpartum Q 29
Before giving a postpartum (PP) client the rubella vaccine, which of the following facts should the nurse include in client teaching?
A. The vaccine is safe in clients with egg allergies.
B. Breastfeeding isn’t compatible with the vaccine.
C. Transient arthralgia and rash are common adverse effects.
D. The client should avoid getting pregnant for 3 months after the vaccine because the vaccine has teratogenic effects.
Correct Answer: D. The client should avoid getting pregnant for 3 months after the vaccine because the vaccine has teratogenic effects.
The client must understand that she must not become pregnant for 3 months after the vaccination because of its potential teratogenic effects. Women who are planning to become pregnant should check with their doctor to make sure they are vaccinated before they get pregnant. Because MMR vaccine is an attenuated (weakened) live virus vaccine, pregnant women who are not vaccinated should wait to get MMR vaccine until after they have given birth. Adult women of childbearing age should avoid getting pregnant for at least four weeks after receiving an MMR vaccine.
Option A: The rubella vaccine is made from duck eggs so an allergic reaction may occur in clients with egg allergies. Vaccines that contain small quantities of egg protein can cause hypersensitivity reactions in some people with egg allergy. Adverse reactions are more likely with vaccines, such as yellow fever and influenza vaccines, that are grown in embryonated eggs.
Option B: The virus is not transmitted into the breast milk, so clients may continue to breastfeed after the vaccination. Early studies found no transmission of rubella virus to breastfed infants. None of 18 infants who were breastfed after maternal vaccination with rubella vaccine (various strains) had detectable antibodies in one study. A study of mothers vaccinated with the Cendehill strain of live, attenuated rubella virus found no transmission of the live virus to their breastfed infants. However, rubella vaccine virus can appear in breastmilk and result in infections in some infants.
Option C: Transient arthralgia and rash are common adverse effects of the vaccine. Transient joint manifestations, ranging from mild arthralgia to severe extensive polyarthritis are a troublesome feature of rubella. These complaints, described as early as 1906 in Osler’s textbook, have been a source of considerable concern in the past, since they may simulate the picture of acute rheumatoid polyarthritis.