Author Question: The nurse is providing care to a laboring woman who is Rh-negative. The patient has a standing ... (Read 61 times)

newbem · **on:** Jun 28, 2018

The nurse is providing care to a laboring woman who is Rh-negative. The patient has a standing prescription to receive RhoGAM, if indicated. When will the nurse plan on administering the RhoGAM, if indicated?

a. Approximately 2 hours prior to birth
b. At the birth of the placenta
c. One hour after the birth of the infant
d. Between 48 and 72 hours after birth of the infant

Question 2

The nurse who suspects that a client has early signs of ectopic pregnancy should be observing her for which symptoms? (Select all that apply.)

a. Pelvic pain
b. Missed period
c. Abdominal pain
d. Unanticipated heavy bleeding
e. Vaginal spotting or light bleeding

fraziera112 · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: D
If the mother is Rh-negative, umbilical cord blood is taken at birth to determine blood type, Rh factor, and antibody titer (direct Coombs test) of the newborn. Rh-negative unsensitized mothers who give birth to Rh-positive infants are given an intramuscular injection of Rho(D) immune globulin (RhoGAM) within 72 hours after birth. If RhoGAM is given to the mother in the first 72 hours after the birth of an Rh-positive infant, Rh antigens present in her blood are destroyed before she forms antibodies to the Rh factor. If the infant is Rh-negative, Rh antibodies are not formed and RhoGAM is not necessary. Patients of the Jehovah's Witness faith decline blood-based products, and RhoGAM is derived from blood. It is the responsibility of the nurse to make sure that patients of this faith understand the characteristics of RhoGAM and are fully informed of the consequences of declining the administration of RhoGAM.

Answer to Question 2

ANS: A, B, C, E
A missed period or spotting can easily be mistaken by the client as early signs of pregnancy. More subtle signs depend on exactly where the implantation occurs. The nurse must be thorough in her assessment because pain is not a normal symptom of early pregnancy. As the fallopian tube tears open and the embryo is expelled, the client often exhibits severe pain accompanied by intraabdominal hemorrhage. This may progress to hypovolemic shock with minimal or even no external bleeding. In about 50 of women, shoulder and neck pain occurs because of irritation of the diaphragm from the hemorrhage.