A patient is a gravida 1, Rh-negative woman at a 28 weeks' ...

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A patient is a gravida 1, Rh-negative woman at a 28 weeks' gestation. The father of her child is Rh positive. The mother is asking the nurse about the effect on her unborn child of RhoGAM that has been ordered. What is the nurse's best reply?
 
  a. Your child will do well after birth once transfusions are administered.
  b. If the baby is Rh negative at birth, he or she will need RhoGAM also.
  c. RhoGAM kills antibodies you make, so your child will be protected.
  d. Your baby may be Rh positive and cause you to make antibodies. These won't affect this baby but could affect future children if RhoGAM isn't given.

Question 2

A 36-week primigravida patient has been admitted to the unit with a blood pressure of 200/120 mm Hg, severe headache, and edema. Which medication does the nurse anticipate that the health care provider will order?
 
  a. Nifedipine (Procardia)
  b. Furosemide (Lasix)
  c. Magnesium sulfate
  d. Terbutaline (Brethine)

[batool]

Answer to Question 1

ANS: D
An Rh-negative mother and an Rh-positive father have the potential for an Rh-positive baby. At birth or during any time that the uterus ruptures, fetal blood circulation can mix with maternal circulation, causing the mother to produce antibodies (active immunity) against Rh-positive blood. This would cause Rh hemolytic disease in children of future pregnancies. Rho(D) immune globulin suppresses the stimulation of active immunity by Rh-positive foreign red blood cells that enter maternal circulation at the time of delivery, at the termination of pregnancy, or during a transfusion of inadequately typed blood. Transfusions may cause further problems. Immune globulin is given to the mother. The drug does not kill antibodies; it suppresses production.

Answer to Question 2

ANS: C
Magnesium sulfate depresses the central nervous system and blocks peripheral nerve transmission, which produces anticonvulsant effects and smooth muscle relaxation. In cases of preeclampsia or eclampsia, magnesium sulfate is used to control seizure activity. Hypertension, headache, and edema are signs of preeclampsia in a pregnant woman. Calcium channel blockers, such as nifedipine, are sometimes given as tocolytic agents. Furosemide is given for diuresis; it may be used in the treatment of hypertension, but not eclampsia. Terbutaline is given as a tocolytic agent.

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