Hemolytic disease is suspected in a mother's second newborn. ...

[Bob-Dole]

Hemolytic disease is suspected in a mother's second newborn. Which factor is important in understanding how this could develop?
 
  a. The mother's first child was Rh positive.
  b. The mother is Rh positive.
  c. Both parents have type O blood.
  d. RhIG (RhoGAM) was given to the mother during her first pregnancy.

Question 2

The nurse is caring for a newborn with hyperbilirubinemia who is receiving phototherapy. Which is an appropriate nursing intervention for this newborn?
 
  a. Apply lotion as prescribed to moisturize skin.
  b. Maintain nothing-by-mouth (NPO) status to prevent nausea and vomiting.
  c. Monitor temperature to prevent hypothermia or hyperthermia.
  d. Keep eye patches on for at least 8 to 12 of every 24 hours.

[LP]

Answer to Question 1

ANS: A
Hemolytic disease of the newborn results from an abnormally rapid rate of red blood cell (RBC) destruction. The major causes of this are Rh and maternal-fetal ABO incompatibility. If an Rh-negative mother has previously been exposed to Rh-positive blood through pregnancy or blood transfusion, antibodies to this blood group antigen may develop so that she is isoimmunized. With further exposure to Rh, the maternal antibodies will agglutinate with the red cells of the fetus who has the antigen and destroy the cells. Hemolytic disease is also caused by ABO incompatibilities. Blood type is the important consideration. If both parents are type O blood, ABO incompatibility would not be a possibility. The mother should have received Rho(D) immune globulin to prevent antibody development after the first pregnancy.

Answer to Question 2

ANS: C
Newborns who are receiving phototherapy are at risk for thermoregulation issues. The nurse must monitor the newborn's temperature closely to rapidly detect either hypothermia or hyperthermia. Lotions are not used. They may predispose the newborn to increased tanning or frying effect. Newborns receiving phototherapy require additional fluid to compensate for increased fluid losses caused by the lights. The eye patches must be in place whenever the child is under the phototherapy lights.

[Bob-Dole]

Excellent

[miss.ashley]

TYSM