A patient who is at 32 weeks' gestation is determined to be at high risk for ABO incompatibility. Which intervention should the nurse anticipate implementing?

Question

1. Intramuscular administration of 300 mcg of Rh immune globulin (RhoGAM) to the patient
2. Notify the patient's primary care provider and document the potential need for treatment of fetal hemolytic anemia in the patient's baby after delivery.
3. Obtain an antibody screen (indirect Coombs' test) to determine whether the patient has developed isoimmunity.
4. Note the potential for ABO incompatibility and plan to carefully assess the patient's neonate for the development of hyperbilirubinemia.

Answer 1

Correct Answer: 4
Rationale 1: RhoGAM is administered to prevent sensitization after exposure to Rh-positive blood.
Rationale 2: Unlike Rh incompatibility, antepartum treatment of ABO incompatibility is not warranted because it does not cause severe anemia.
Rationale 3: An antibody screen (indirect Coombs' test) is done to determine whether an Rh-negative woman is sensitized (has developed isoimmunity) to the Rh antigen.
Rationale 4: Unlike Rh incompatibility, antepartum treatment of ABO incompatibility is not warranted because it does not cause severe anemia. As part of the initial assessment, however, the nurse should note whether the potential for an ABO incompatibility exists in order to alert caregivers to the need for carefully assessing the newborn for the development of hyperbilirubinemia.