An infant with type O Rh-positive blood becomes visibly jaundiced at 12 hours of age. The mother with type O Rh-negative blood asks why this has occurred. How should the nurse respond?
1. "The RhoGAM you received at 28 weeks' gestation did not prevent alloimmunization."
2. "Your body has made antibodies against the baby's blood that are destroying her red blood cells."
3. ""The red blood cells of your baby are breaking down because you both have type O blood."
4. "Your baby's liver is too immature to eliminate the red blood cells that are no longer needed."
2
Explanation:
1. Although this statement is true, the term "alloimmunization" is not likely to be understood by the client. It is better to explain what is happening using more understandable terminology.
2. Alloimmune hemolytic disease, also known as erythroblastosis fetalis, occurs when an Rh-negative mother is pregnant with an Rh-positive fetus and maternal antibodies cross the placenta. Maternal antibodies enter the fetal circulation, then attach to and destroy the fetal RBCs. The fetal system responds by increasing RBC production. Jaundice is the result.
3. Mother and baby's both having type O blood is not a problem. ABO incompatibility occurs if the mother is O and the baby is A or B.
4. The infant's liver is indeed too immature to eliminate red blood cells, but the hemolysis from the maternal antibodies is the cause of the jaundice.
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