What is the initial action the nurse should take for a newborn of an HIV-positive mother?

For a newborn of an HIV-positive mother, timely and appropriate actions are critical to ensure the infant's health and management of any potential HIV infection. Performing virologic testing within 48 hours of birth is considered the best initial action. This is because virologic testing, which typically involves methods such as polymerase chain reaction (PCR), directly detects the presence of the virus itself rather than relying on antibody responses, which may not be present in newborns right away.

Newborns can have maternal antibodies transferred during pregnancy, which complicates the interpretation of antibody tests like ELISA. These tests can lead to false positives due to the presence of maternal HIV antibodies in the newborn’s system. Therefore, immediate virologic testing within the first couple of days is vital to determine if the newborn has been infected and to allow for early interventions, such as antiretroviral therapy, which significantly improves outcomes if the infant tests positive for HIV.

In summary, performing virologic testing as an initial action provides essential information for the timely management of the newborn, helping to establish a diagnosis and starting treatment if necessary.