The client with blood type A, Rh-negative, delivered yesterday. ...

[Mimi]

The client with blood type A, Rh-negative, delivered yesterday. Her infant is blood type AB, Rh-positive. Which statement indicates that teaching has been effective?
 
  1. I need to get RhoGAM so I don't have problems with my next pregnancy.
  2. Because my baby is Rh-positive, I don't need RhoGAM.
  3. If my baby had the same blood type I do, it might cause complications.
  4. Before my next pregnancy, I will need to have a RhoGAM shot.

Question 2

A patient attending a prenatal class asks why episiotomies are performed.
 
  The nurse explains that risk factors that predispose women to episiotomies include: Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Large or macrosomic fetus.
  2. Use of forceps.
  3. Shoulder dystocia.
  4. Maternal health.
  5. Shorter second stage.

[sokh]

Answer to Question 1

1
Explanation: 1. Rh-negative mothers who give birth to Rh-positive infants should receive Rh immune globulin (RhoGAM) to prevent alloimmunization.

Answer to Question 2

1,2,3
Rationale 1: A large fetus places a woman at risk for an episiotomy to prevent lacerations.
Rationale 2: Forceps delivery can damage the perineum, and an episiotomy may be performed to enlarge the opening for the fetus.
Rationale 3: To enlarge the opening of the perineum to afford the traction placed on the fetus, an episiotomy may be performed.
Rationale 4: Current research indicates that there are no maternal advantages in performing routine episiotomy.
Rationale 5: There are no scientific data that episiotomies yield a shorter second stage.