A client who is Rh-negative should receive Rho(D) immune globulin at which of the following times?
Routinely at 28 weeks of gestation.
After a spontaneous abortion.
Within 72 hours following delivery.
Following an amniocentesis.
Correct Answer : A,B,C,D
Choice A rationale
Routinely administering Rho(D) immune globulin at 28 weeks of gestation is a standard prophylactic measure for Rh-negative pregnant clients. This timing provides protection against potential sensitization from fetal red blood cells that may cross the placenta during the third trimester, minimizing the risk of alloimmunization and hemolytic disease of the newborn.
Choice B rationale
A spontaneous abortion, regardless of gestational age, involves a potential mixing of maternal and fetal blood, especially if the fetus is Rh-positive. Administering Rho(D) immune globulin prevents the Rh-negative mother from developing antibodies to the Rh factor, thereby protecting future Rh-positive pregnancies from hemolytic disease.
Choice C rationale
Administering Rho(D) immune globulin within 72 hours following delivery of an Rh-positive infant is crucial for Rh-negative mothers. This prevents the mother from becoming sensitized to the Rh antigen after exposure to fetal red blood cells during birth. If sensitization occurs, subsequent Rh-positive pregnancies could be affected by hemolytic disease.
Choice D rationale
Amniocentesis, a procedure involving needle insertion into the uterus, carries a risk of fetomaternal hemorrhage and potential exposure of an Rh-negative mother to Rh-positive fetal blood. Administering Rho(D) immune globulin following this procedure is a prophylactic measure to prevent maternal sensitization and protect future Rh-positive pregnancies. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["42"]
Explanation
Step 1 is: Calculate the safe maximum dosage per day for the child. 7 mg/kg/day × 6 kg = 42 mg/day. The safe maximum dosage per day for this child is 42 mg.
Correct Answer is B
Explanation
Choice A rationale
Episiotomy involves an incision in the perineum to enlarge the vaginal opening. While it can facilitate delivery, it does not directly address the mechanical obstruction caused by the shoulder impacting against the maternal symphysis pubis, which is the hallmark of shoulder dystocia.
Choice B rationale
The McRoberts maneuver is most commonly used first to relieve shoulder dystocia. It involves hyperflexing the maternal hips onto the abdomen, which flattens the sacrum, rotates the symphysis pubis cephalad, and often allows the impacted anterior shoulder to clear underneath the symphysis pubis, facilitating delivery.
Choice C rationale
The Zavanelli maneuver involves pushing the fetal head back into the birth canal and performing a Cesarean section. This is a highly invasive and often last-resort maneuver, employed only after less invasive methods like McRoberts and suprapubic pressure have failed due to its significant risks.
Choice D rationale
Fundal pressure involves applying downward pressure on the top of the uterus. This maneuver is contraindicated in shoulder dystocia because it can worsen the impaction of the fetal shoulder against the maternal symphysis pubis, potentially leading to more severe injury to the fetus or mother.
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