The nurse is caring for a postpartal woman and reviews the ...

[Medesa]

The nurse is caring for a postpartal woman and reviews the following lab results in her medical record: HBsAg-negative, rubella titer less than 1:8/1:10, Rh-negative with Rh-positive infant.
 
  Which injections will the nurse expect to be ordered?
  a. Hepatitis B immune globulin and MMR today
  b. MMR and Rho(D) immune globulin (RhoGAM) today
  c. Rho(D) immune globulin (RhoGAM) and hepatitis B immune globulin today
  d. Rho(D) immune globulin (RhoGAM) today and MMR in 3 months

Question 2

The nurse tells a postpartal woman that her baby will need hepatitis B vaccine. The mother says she does not want her baby to have a shot and refuses to sign the consent. The nurse will
 
  a. administer the vaccine without consent.
  b. note the refusal in the mother's and baby's chart.
  c. tell her she will harm her baby if she does not consent.
  d. tell the mother that it is required by law.

[mrphibs]

Answer to Question 1

ANS: D
The woman needs RhoGAM today and will need an MMR since her rubella titer is low. Because it is a live vaccine, the MMR should be given in 3 months. She does not need hepatitis B immune globulin.

Answer to Question 2

ANS: B
Although hepatitis B vaccine is recommended, patients have a right to refuse. The refusal should be documented in the mother's and baby's chart. The nurse should never administer the vaccine without consent. Telling the mother that she will harm her baby if she does not consent is coercive. The vaccine is recommended and is required for admission to schools, but parents still have a right to refuse.

[Medesa]

TY

[mrphibs]

You're welcome