A clinic nurse is planning when to administer Rh immune globulin (RhoGAM) to an Rh-negative pregnant patient. When should the first dose of RhoGAM be administered?

1. After the birth of the infant
2. 1 month postpartum
3. During labor
4. At 28 weeks' gestation


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Rationale 1: After birth would be too late for the first dose of RhoGAM if transplacental hemorrhage, which is possible during pregnancy, has occurred.
Rationale 2: 1 month postpartum would be too late for the first dose of RhoGAM if transplacental hemorrhage, which is possible during pregnancy, has occurred.
Rationale 3: During labor would be too late for the first dose of RhoGAM if transplacental hemorrhage, which is possible during pregnancy, has occurred.
Rationale 4: Since transplacental hemorrhage is possible during pregnancy, an antibody screen is performed on an Rh-negative woman at 28 weeks' gestation. If she has no antibody titer, she is given an IM injection of 300 mcg Rh immune globulin (RhoGAM).

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