The nurse is providing care to a laboring woman who is Rh-negative. The patient has a standing prescription to receive RhoGAM, if indicated. When will the nurse plan on administering the RhoGAM, if indicated?
a. Approximately 2 hours prior to birth
b. At the birth of the placenta
c. One hour after the birth of the infant
d. Between 48 and 72 hours after birth of the infant
ANS: D
If the mother is Rh-negative, umbilical cord blood is taken at birth to determine blood type, Rh factor, and antibody titer (direct Coombs test) of the newborn. Rh-negative unsensitized mothers who give birth to Rh-positive infants are given an intramuscular injection of Rho(D) immune globulin (RhoGAM) within 72 hours after birth. If RhoGAM is given to the mother in the first 72 hours after the birth of an Rh-positive infant, Rh antigens present in her blood are destroyed before she forms antibodies to the Rh factor. If the infant is Rh-negative, Rh antibodies are not formed and RhoGAM is not necessary. Patients of the Jehovah's Witness faith decline blood-based products, and RhoGAM is derived from blood. It is the responsibility of the nurse to make sure that patients of this faith understand the characteristics of RhoGAM and are fully informed of the consequences of declining the administration of RhoGAM.
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