Which maternal-child patient should the nurse see first?
1. Blood type O, Rh-negative
2. Indirect Coombs' test negative
3. Direct Coombs' test positive
4. Blood type B, Rh-positive
3
Rationale 1: This patient is Rh-negative, but there is no indication that the alloimmunization has occurred.
Rationale 2: An indirect Coombs' test looks for Rh antibodies in the maternal serum; a negative result indicates the patient has not been alloimmunized.
Rationale 3: A direct Coombs' test looks for Rh antibodies in the fetal blood circulation. A positive result indicates that that there is an Rh incompatibility between mother and infant, and that the baby is making anti-Rh antibodies, which in turn leads to hemolysis. This infant is at risk for anemia and hyperbilirubinemia.
Rationale 4: This patient's blood type creates no problems.
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