A nurse in a clinic is teaching the mother of a 4-month-old infant who has been breastfed. The mother plans to switch her infant to an iron-fortified formula. Which of the following should be included in the teaching?

Choice A reason: The indirect Coombs test is used to screen for antibodies in the mother's blood that could potentially cause hemolytic disease in the newborn if they are Rh-positive. A positive result indicates that the mother has developed antibodies that could cross the placenta and attack the red blood cells of an Rh-positive fetus.

Choice B reason: The indirect Coombs test does not detect Rh-negative antibodies in the newborn's blood. Instead, it is used to detect antibodies in the mother's blood. The direct Coombs test is used to detect antibodies that are already attached to the red blood cells of the newborn.

Choice C reason: The indirect Coombs test does not determine if kernicterus will occur in the newborn. Kernicterus is a form of brain damage that can result from very high levels of bilirubin in a baby's blood. It is not directly related to the presence of antibodies detected by the indirect Coombs test.

Choice D reason: The indirect Coombs test does not determine the presence of maternal antibodies in the newborn's blood. This is assessed by the direct Coombs test, which checks for antibodies bound to the surface of the newborn's red blood cells, indicating that the immune system is attacking them.

Choice a reason:
Methylergonovine is a medication used to prevent postpartum hemorrhage, which is excessive bleeding following childbirth. It works by causing the uterine muscles to contract, thereby reducing blood loss. Postpartum hemorrhage is a significant cause of maternal morbidity and mortality worldwide, and methylergonovine is one of the medications used as a prophylactic measure to manage this risk.

Choice b reason:
While postpartum infections are a concern after childbirth, methylergonovine is not used to prevent infections. Postpartum infections can occur in different parts of the body, such as the uterus (endometritis), the urinary tract, or the site of an episiotomy or cesarean section incision. Prevention of postpartum infections typically involves hygiene practices, antibiotic prophylaxis when indicated, and monitoring for signs of infection.

Choice c reason:
Thromboembolic events, which include deep vein thrombosis and pulmonary embolism, are also a risk during the postpartum period. However, methylergonovine is not used to prevent these conditions. Prevention of thromboembolic events in the postpartum period may involve the use of anticoagulants, mechanical methods such as compression stockings, and early mobilization.

Choice d reason:
Hypertension, or high blood pressure, may be observed during the postpartum period, but methylergonovine is not indicated for the prevention of hypertension. Management of postpartum hypertension typically includes antihypertensive medications and monitoring of blood pressure levels. Methylergonovine can actually cause an increase in blood pressure as a side effect, so it must be used cautiously in individuals with hypertension.