Rho immune globulin will be ordered postpartum if which situation occurs?

A. "I should pad the mattress in my baby's crib so that he will be more comfortable when he sleeps. Placing pads, pillows, or any soft bedding in a crib increases the risk of suffocation and sudden infant death syndrome (SIDS). The American Academy of Pediatrics (AAP) recommends a firm mattress with a tight-fitting sheet and no additional padding for infant safety.

B. "I will place my baby on his stomach when he is sleeping." Placing a baby on their stomach to sleep significantly increases the risk of SIDS. The safest sleep position for all infants is on their back, as this reduces the risk of airway obstruction and suffocation.

C. "I should remove extra blankets from my baby's crib." This statement shows correct understanding of safe sleep practices. Loose blankets and soft bedding pose a serious risk for SIDS and suffocation. Instead, parents are encouraged to use sleep sacks or wearable blankets to keep the baby warm without loose items in the crib.

D. "I should place my baby's crib next to the heater to keep him warm during the winter." Placing a crib near a heater or direct heat source can lead to overheating, which is a known risk factor for SIDS. It's important to maintain a moderate room temperature and avoid direct heat exposure to ensure the infant's safety and comfort.

A. Suction the nose with a bulb syringe: While clearing nasal secretions is important, suctioning the mouth takes priority over the nose. Stimulating the nares before clearing the oral airway can cause aspiration if secretions are present in the mouth, especially in newborns with underdeveloped airway protective reflexes.

B. Use a suction catheter with low negative pressure: Suction catheters are typically reserved for cases requiring deeper or more controlled suctioning, such as in NICU settings. For routine post-delivery care, a bulb syringe is the safest and most effective tool to clear the newborn’s airway without risking trauma or excessive negative pressure.

C. Suction the mouth with a bulb syringe: Clearing the mouth first is the priority to prevent aspiration and ensure an open airway. Bulb syringe suctioning is gentle and effective for removing excess mucus or amniotic fluid from the oropharynx, facilitating spontaneous breathing and reducing respiratory distress in the immediate newborn period.

D. Turn the newborn on his side: Positioning the newborn on their side may aid in drainage of secretions, but it is not sufficient as a first action when secretions are visibly bubbling from the nose and mouth. Active suctioning is necessary to clear the airway and prevent obstruction or aspiration as the first step and the head should be placed in a sniffing position rather than turning.