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

[torybrooks]

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

The nurse is reviewing labs on a new admit. The client's hemoglobin is 8.0; platelets are 75,000, AST 75. Which nursing action is best?
 
  1. Contact the physician.
  2. Request the labs to be redrawn.
  3. Assess blood pressure.
  4. Determine the client's blood type and Rh.

[amandanbreshears]

Answer to Question 1

1
Rationale:
1. Rh-negative mothers who give birth to Rh-positive infants should receive Rh immune globulin (RhoGAM) to prevent alloimmunization, which could cause fetal anemia and other complications during the next pregnancy.
2. Rh-negative mothers who give birth to Rh-positive infants should receive Rh immune globulin (RhoGAM) to prevent alloimmunization.
3. It is specifically the Rh factor that causes complications; ABO grouping does not cause alloimmunization.
4. Rh-negative mothers who give birth to Rh-positive infants should receive Rh immune globulin (RhoGAM). The injection must be given with 72 hours after delivery to prevent alloimmunization.

Answer to Question 2

1
Rationale:
1. This client has HELLP syndrome, a life-threatening condition. Further orders are needed from the physician.
2. Redrawing the labs is not the best action; acting on the labs that indicate HELLP is a higher priority.
3. The labs indicate HELLP syndrome. The blood pressure is likely to be high, but notifying the physician of this life-threatening set of labs is a higher priority.
4. Although blood type and RH would need to be known after delivery to determine if the client requires RhoGAM, this is not the highest priority.