A woman has been admitted to the labor and delivery unit with a macular rash and lymphadenopathy. Lab tests reveal WBC count of 11,000, a platelet count of 200,000, creatinine of 0.9, and the nontreponemal antibody test is positive. What should the nurse do next?

Notify the physician.


• A positive nontreponemal test, along with a rash and lymphadenopathy, are indicative of secondary syphilis.

• Primary syphilis presents with a single sore called a chancre. If it is not treated, secondary syphilis presents later with a non-itchy rash often on the palms of the hands and soles of the feet, two-to-eight weeks after the first illness.

• Secondary syphilis is curable with treatment, but without treatment, it will progress to the latent and then tertiary stages. Then it is no longer curable.

• The physician should be notified immediately so proper treatment can be initiated.

• Syphilis infection during pregnancy can result in stillbirth, prematurity, and congenital syphilis.

• Incorrect: Increasing fluid intake, adopting a dorsal recumbent position, and illicit drug use are unrelated to secondary syphilis and have no impact on treatment.

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