Author Question: An adolescent whose leg was crushed when she fell off a horse is admitted to the emergency ... (Read 47 times)

KWilfred · **on:** Jun 28, 2018

An adolescent whose leg was crushed when she fell off a horse is admitted to the emergency department. She has completed the tetanus immunization series, receiving the last tetanus toxoid booster 8 years ago.

What care is necessary for therapeutic management of this adolescent to prevent tetanus?

a. Tetanus toxoid booster is needed because of the type of injury.
b. Human tetanus immunoglobulin is indicated for immediate prophylaxis.
c. Concurrent administration of both tetanus immunoglobulin and tetanus antitoxin is needed.
d. No additional tetanus prophylaxis is indicated. The tetanus toxoid booster is protective for 10 years.

Question 2

A woman who is Rh-negative is pregnant with her first child, and her husband is Rh positive. During her 12-week prenatal visit, she tells the nurse that she has been told that this is dangerous. What should the nurse tell her?

a. That no treatment is necessary
b. That an exchange transfusion will be necessary at birth
c. That no treatment is available until the infant is born
d. That administration of Rh immunoglobulin is indicated at 26 to 28 weeks of gestation

cascooper22 · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: A
Protective levels of antibody are maintained for at least 10 years. Children with serious tetanus-prone wounds, including contaminated, crush, puncture, or burn wounds, should receive a tetanus toxoid booster prophylactically as soon as possible. This adolescent has circulating antibodies. The immunoglobulin is not indicated.

Answer to Question 2

ANS: D
The goal is to prevent isoimmunization. If the mother has not been previously exposed to the Rh-negative antigen, Rh immunoglobulin (RhIg) is administered at 26 to 28 weeks of gestation and again within 72 hours of birth. The intramuscular administration of RhIg has virtually eliminated hemolytic disease of the infant secondary to the Rh factor. Unless other problems coexist, the newborn will not require transfusions at birth.