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Answer to Case Study #2:Reassure Maria that many people are afraid of the finger stick and that you will be gentle. Explain to her the importance of testing, emphasizing the potential complications of untreated syphilis, which include damage to the heart and nervous system and even death. Explain to her the risk that untreated syphilis may pose to her baby, emphasizing that syphilis can be transmitted to a baby during pregnancy, causing stillbirth or the death of the baby shortly after delivery. Transmission to a baby can be avoided if the woman is treated early in pregnancy. Inquire about how she feels about her marriage and her circumstances in general. Make sure that she knows how to use condoms, and have her practice putting a condom on a penis model. Discuss strategies for encouraging her husband to use condoms, perhaps emphasizing the potential risk of STIs to the baby, if this might make condom use more palatable to him. If female condoms are available in your area, discuss with Maria the possibility of her using them.
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