During her first prenatal visit to the clinic at 7 weeks' gestation, a 24-year-old primiparous patient comments, "My blood type is A negative, and my husband's blood type is B positive
Will that cause problems with my pregnancy?" The nurse's best response would be: 1. "There is no danger to your baby, but there could be a few minor complications for you. Let's talk about what we can do to prevent those."
2. "We will do a blood test to see whether your body is responding to the baby's blood type. If so, we will give the baby some medication to prevent harm."
3. "Because your partner is positive and you are negative, there is some risk to the baby, but because this is your first pregnancy, the risks are very small."
4. "If you were O negative, you might have ABO incompatibility because of your partner's blood type; but since you are type A, there should be no problem."
3
Rationale 1: This patient is at risk for Rh incompatibility because she is Rh-negative and the father of the baby is Rh-positive.
Rationale 2: It is recommended that a Coombs' blood test be drawn to assess for antibody formation at the first prenatal visit and again at 28 weeks. Rh immune globulin (RhoGAM) will be given to the mother (not the fetus) at 28 weeks.
Rationale 3: This client is at risk for Rh incompatibility because she is Rh-negative and the father of the baby is Rh-positive. Because this is her first pregnancy, it is extremely unlikely that she has been exposed to Rh-positive blood, which would stimulate the development of antibodies. These antibodies cross the placenta and cause fetal hemolysis, which can lead to severe anemia that could cause fetal loss. It is recommended that a Coombs' blood test be drawn to assess for antibody formation at the first prenatal visit and again at 28 weeks. Rh immune globulin (RhoGAM) will be given to the mother (not the fetus) at 28 weeks, and again after delivery if the baby is Rh-positive, to prevent antibody formation.
Rationale 4: This is not an issue of ABO incompatibility.
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