What significant guideline should a nurse follow when caring for a pregnant client who is taking antiretroviral therapy?

Continuing antiretroviral therapy during pregnancy is vital to ensure the health of both the mother and the developing fetus. Antiretroviral medications are crucial in managing HIV infection and reducing the viral load to an undetectable level, thereby significantly decreasing the risk of mother-to-child transmission of the virus during pregnancy, labor, and breastfeeding. When the mother maintains effective treatment, the chances of transmitting HIV to the baby drop dramatically, and the overall health outcomes improve for both mother and child.

Discontinuing or delaying therapy can increase the risk of maternal HIV progression, which may lead to adverse health effects for the mother and a higher risk of transmission to the fetus. Modification of therapy is not typically based solely on fetal heart rate monitoring but rather requires careful assessment of the overall clinical scenario, including viral load and any potential drug interactions. Therefore, the guideline to continue therapy is essential for ensuring the safety and health of both the pregnant patient and the fetus.