NURS 372 Rh Incompatibility Answer Key PDF

K. Berga Updated for BNUR 3002 - 2023 In Class Activity – NURS 372 Rh Incompatibility ANSWER SHEET 1. Potential for Rh incompatibility exists when the mother is Rh negative (lacks the antigen) and the father is Rh positive. 2. If the...

K. Berga Updated for BNUR 3002 - 2023 In Class Activity – NURS 372 Rh Incompatibility ANSWER SHEET 1. Potential for Rh incompatibility exists when the mother is Rh negative (lacks the antigen) and the father is Rh positive. 2. If the fetus is Rh positive, and the mother is negative, the mother may be sensitized through mixing of maternal and fetal blood. 3. The mother’s body recognizes the antigen as foreign and begins making antibodies against them. This is called iso- immunization. 4. If the fetus is positive, antibodies from the mother cross the placenta, atttach to fetal RBCs and begin to hemolyze them. This can lead to haemolytic disease of the newborn. 5. To prevent this disease from occurring, Rh immunoglobulin (RhIg) is given to the mother to prevent the mother from making antibodies and causing possible harm to the baby. 6. When a mother is Rh negative, she is checked for anti-Rh antibodies at the first prenatal visit to determine if she is sensitized to the Rh antigen. This is called an Indirect Coomb’s test (checking for sensitization). A routine antibody screen is done at the first prenatal visit to determine if the woman is sensitized to the Rh antigen (done on the mother’s blood to measure the number of Rh positive antiboides) 7. If Rh antibodies are present, maternal sensitization has occurred and the infant will be monitored closely for isoimmune haemolytic disease. If she is not sensitized (unsensitized), Rh immune globulin will be given at 28 weeks gestation. 8. RhIg (WinRho) is also administered after an amniocentesis or if there is any vaginal bleeding, where fetal and maternal blood may be mixing. It is also given again within 72 hours after birth. K. Berga Updated for BNUR 3002 - 2023 9. A Direct Coomb’s test is done on the infant’s blood to detect antibody-coated Rh-positive red blood cells. Patient Health Teaching Considerations – Answer Key What is the Rh Factor? Just as there are different major blood groups, such as type A / type B, there also is an Rh factor. The Rh factor is a protein that can be present on the surface of RBCs. Most people have the Rh factor—they are Rh positive. Others do not have the Rh factor—they are Rh negative. How does someone get it? It is genetically inherited—passed down through parents’ genes to their children. If the mother is Rh negative and the father is Rh positive, the fetus can inherit the Rh gene from the father and could be either Rh positive or Rh negative. If the mother and father are both Rh negative, the baby also will be Rh negative. What happens if I’m pregnant and Rh Negative? A blood test, called an antibody screen, can show if you have developed antibodies to Rh- positive blood and how many antibodies have been made. If you are Rh negative and there is a possibility that your baby is Rh positive, your health care provider may request this test during your first trimester and again during week 28 of pregnancy. How does Rh sensitization occur during pregnancy? During pregnancy, the woman & fetus do not share blood systems. However, a small amount of blood from the fetus can cross the placenta into the woman’s system. This sometimes may happen during pregnancy, labor, and birth. It also can occur if an Rh-negative woman has had any of the following during pregnancy: Amniocentesis. Chorionic villus sampling (CVS), Bleeding during pregnancy, Manual rotation of a baby in a breech presentation before labor. Blunt trauma to the abdomen during pregnancy. RhIg is given to Rh-negative women in the following situations: At around the 28th week of pregnancy to prevent Rh sensitization for the rest of the pregnancy AND Within 72 hours after the delivery of an Rh-positive infant, After a miscarriage, abortion, or ectopic pregnancy, After amniocentesis or chorionic villus sampling K. Berga Updated for BNUR 3002 - 2023 Can I still develop antibodies after I’ve had a loss? Yes. It also is possible to develop antibodies after a miscarriage, an ectopic pregnancy, or an induced abortion. If an Rh-negative woman becomes pregnant after one of these events, she does not receive treatment, and the fetus is Rh positive, the fetus may be at risk of Rh-related problems. Can this be prevented? Yes. If you are Rh negative, you will be given a shot of Rh immunoglobulin (RhIg). RhIg is made from donated blood. When given to a nonsensitized Rh-negative person, it targets any Rh- positive cells in the bloodstream and prevents the production of Rh antibodies. When given to an Rh-negative woman who has not yet made antibodies against the Rh factor, RhIg can prevent fetal hemolytic anemia in a later pregnancy. What if I’m Rh sensitized and my baby is Rh positive? RhIg is not helpful if you are already Rh sensitized. If you are Rh sensitized, you will be monitored during pregnancy to check the condition of your fetus. If tests show that your baby has severe anemia, it may be necessary to deliver your baby early (before 37 weeks of pregnancy) or give a blood transfusion while your baby is still in your uterus (through the umbilical cord). If the anemia is mild, your baby may be delivered at the normal time. After delivery, your baby may need a transfusion to replace the blood cells.