North American Registry of Midwives (NARM) Practice Exam

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What is a recommended action for an infant whose mother had varicella infection close to delivery?

Provide routine vaccinations
Administer VZIG at birth
No action is required
Offer immediate breastfeeding

The correct answer is: Administer VZIG at birth

For an infant whose mother had varicella infection close to delivery, administering Varicella Zoster Immune Globulin (VZIG) at birth is the recommended action. This is because VZIG serves as a passive immunization strategy, providing immediate but temporary immunity to the infant against the varicella virus. When a mother is infected with varicella (chickenpox) shortly before delivery, there is a risk that the infant may be exposed to the virus during delivery or shortly thereafter. To mitigate the risk of developing varicella and experiencing its potential complications, VZIG is administered to help protect the newborn. The efficacy of VZIG is notably high when given within 72 hours of exposure to the virus. The other actions may not offer the timely protection needed. Routine vaccinations typically occur at scheduled intervals, and immediate breastfeeding, while beneficial for many reasons including the transfer of antibodies from the mother, does not provide the targeted immune response needed for varicella exposure. In cases where no action is taken, the infant remains vulnerable to the infection without any protective measures. Thus, the application of VZIG is a crucial and specific intervention aimed at safeguarding the infant during this critical time.