Author Question: Fraternal twins are delivered by your Rh-negative client. Twin A is Rh-positive and twin B is ... (Read 119 times)

daltonest1984 · **on:** Jun 28, 2018

Fraternal twins are delivered by your Rh-negative client. Twin A is Rh-positive and twin B is Rh-negative. Prior to administering Rho(D) immune globulin (RhoGAM), the nurse should determine the results of the:

a. direct Coombs test of twin A.
b. direct Coombs test of twin B.
c. indirect Coombs test of the mother.
d. transcutaneous bilirubin level for both twins.

Question 2

Which assessment finding indicates the development of preeclampsia in the antepartum client?

a. Slight edema of feet and ankles.
b. Increased urine output
c. Blood pressure of 128/80 mm Hg
d. Weight gain of 3 pounds in 1 week

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

Answer to Question 1

ANS: C
Administration of RhoGAM is based on the results of the indirect Coombs test on the client. A negative results confirms that the mother has not been sensitized by the positive Rh factor of twin A and that RhoGAM is indicated. A direct Coombs test is a diagnostic test used to determine maternal antibodies in fetal blood and to guide treatment of the newborn when Rh and ABO incompatibilities occur. Transcutaneous bilirubin is a noninvasive measure to determine the level of bilirubin in a newborn.

Answer to Question 2

ANS: D
Generalized edema often occurs with preeclampsia. Edema may first manifest as a rapid weight gain. Normal weight gain in the second and third trimesters is 1 pound per week; slight edema of feet and ankles, increased urine output, and blood pressure of 128/80 mm Hg are normal findings in pregnancy.