The patient indicates to the clinic nurse that she is trying to become pregnant. The clinic nurse reviews the patient's chart and notes the following laboratory values: blood type O-, RPR nonreactive, rubella nonimmune, HCT 35%
Which laboratory value is most concerning to the nurse?
a. HCT 35%
b. Blood type O-
c. RPR nonreactive
d. Rubella nonimmune
ANS: D
Rubella nonimmune indicates that the patient does not have immunity against rubella and is therefore susceptible to the infection. Exposure to rubella, or German measles, in the first trimester is associated with fetal congenital anomalies. The client needs a rubella immunization and must not become pregnant within the next 28 days. Although a HCT of 35% is low, women of childbearing age may have mild anemia associated with menstruation. A blood type of O- means that the client will require RhoGAM but is not of concern in the preconception period. A nonreactive RPR indicates that the patient has not been exposed to syphilis.
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