Author Question: For the client who delivered at 6:30 AM on January 10, Rho(D) immune globulin (RhoGAM) must be ... (Read 96 times)

daltonest1984 · **on:** Jun 28, 2018

For the client who delivered at 6:30 AM on January 10, Rho(D) immune globulin (RhoGAM) must be administered prior to:

a. 6:30 AM on January 13.
b. 6:30 PM on January 13.
c. 6:30 PM on January 14.
d. 6:30 AM on January 15.

Question 2

A patient reports to the emergency room nurse that she is 10 weeks pregnant, with unilateral pelvic pain, shoulder pain, and faintness. Her color is pale, she is diaphoretic, and her heart rate is 140 bpm. What is the nurse's priority action?

a. Initiate an ordered IV of lactated Ringer's at 200 mL/hr.
b. Take the patient for her ordered pelvic ultrasound.
c. Ask the patient if she has had any recent vaginal bleeding.
d. Ask the patient if she has ever been told she has had salpingitis.

asware1 · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: A
Rho(D) immune globulin (RhoGAM) must be administered within 72 hours after the birth of an Rh-positive infant. 6:30 PM on January 13, 6:30 PM on January 14, and 6:30 AM on January 15 do not fall within the established time frame.

Answer to Question 2

ANS: A
This patient is presenting with classic signs of an ectopic pregnancy and hypovolemic shock. This is an obstetric emergency. Symptoms include sudden, severe pain in one of the lower quadrants of the abdomen as the tube tears open and the embryo is expelled into the pelvic cavity, often with profuse abdominal hemorrhage. Radiating pain under the scapula may indicate bleeding into the abdomen caused by phrenic nerve irritation. Hypovolemic shock (acute peripheral circulatory failure from loss of circulating blood) is a major concern because systemic signs of shock may be rapid and extensive without external bleeding. The nurse must first start the IV to initiate rapid fluid replacement. Further assessment will result in a delay of care.