A charge nurse is teaching a newly licensed nurse about Rho(D) immune globulin administration. Which of the following should the charge nurse include as an indication for the administration of Rho(D) immune globulin?

When reviewing infection control procedures in a newborn nursery, the nurse manager should instruct the newly hired nurses to place newborn bassinets at least 3 feet apart. This practice helps prevent the spread of infections between infants by minimizing close contact and reducing the risk of droplet transmission.

Option a) Maintaining airborne precautions in the nursery is not necessary unless there is a specific airborne infectious disease outbreak or a newborn with a known airborne infection. Standard precautions, including hand hygiene and proper use of personal protective equipment, are generally sufficient to prevent the spread of infections in a newborn nursery.

Option b) Placing the newborn's foot on a sterile field during a heelstick is not necessary for routine procedures. However, a clean and disinfected surface should be used to perform the heelstick to minimize the risk of introducing pathogens. Sterile fields are typically reserved for sterile procedures in an operating room or other controlled environments.

Option d) Allowing parents to enter the nursery if they are wearing a mask is not a standard infection control practice. In general, only authorized personnel should enter the nursery, and parents or visitors should follow any specific visiting policies in place. If there are concerns about respiratory infections or outbreaks, additional visitor restrictions or requirements may be implemented.

This is the action that the nurse should take after recognizing an early deceleration of the fetal heart rate tracing. Early decelerations are symmetrical decreases and return-to-normal linked to uterine contractions¹. The decrease in heart rate occurs gradually, and the nadir of the deceleration occurs at the same time as the peak of the uterine contraction³. Early decelerations are caused by compression of the fetus's head during a uterine contraction, which can stimulate the vagus nerve and cause a decrease in the fetal heart rate⁴. Early decelerations are nothing to be alarmed about¹. They are considered normal and benign, as they do not affect fetal oxygenation or well-being³. Therefore, the nurse should continue to monitor the client and the fetal heart rate tracing and document the findings.

The other options are not correct because they are not appropriate actions for early decelerations.
a) Assist the client to lay on her right side.
This is not an appropriate action for early decelerations, as they are not caused by maternal position or uteroplacental insufficiency. Changing the maternal position may help improve fetal oxygenation and blood flow in cases of late or variable decelerations, which are signs of fetal distress¹. However, early decelerations do not indicate fetal distress and do not require any intervention.
c) Discontinue the oxytocin.
This is not an appropriate action for early decelerations, as they are not caused by oxytocin administration or uterine hyperstimulation. Oxytocin is a hormone that stimulates uterine contractions and can be used to induce or augment labor. However, excessive or prolonged use of oxytocin can cause uterine fatigue and reduce its ability to contract after delivery, leading to uterine atony and postpartum hemorrhage². Oxytocin can also cause late or variable decelerations, which are signs of fetal distress¹. However, early decelerations do not indicate fetal distress and do not require any intervention.

d) Administer oxygen at 8 L/min per mask.
This is not an appropriate action for early decelerations, as they are not caused by fetal hypoxia or acidosis. Oxygen administration may help improve fetal oxygenation and blood flow in cases of late or variable decelerations, which are signs of fetal distress¹. However, early decelerations do not indicate fetal distress and do not require any intervention.