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Rhogam is not effective if she is already sensitized What can happen?Hemolysis
Nursing assessments:-MaternalLabsTiter- (Indirect coomb’s test)Usually don’t have any s/s -Post partum Assessment Mom Rh- umbilical cord blood is taken at delivery to determine blood type Hr factor and antibody titer Rh- moms who gave birth to Rh+ baby- even if unsensitized0 getting an IM injection of rhogam- IM If fetus is Rh- and Rh antibody formation doesn’t occur Be open and honest to family. -NewbornHemolysisjaundice Direct coombs- if pos, check bili levelbili light and treatment Optical density- amount of bilirubin present in amniotic fluidUS- evaluation of fetusDoppler studies for cardiac function and blood flow in vesselsIf severely affected- intrauterine erythrocytes into umbilical cord by percutaneous umbilical blood transfusion ABO Incompatibility: Define: Mom is O and baby is anything other than O- will get checked with cord blood to check for potential ABO incompatibility. Types A, B, and AB blood contain an antigen that is not present in O blood and will cause O blood to create antibodies against it-Antibodies may be either IgG or IgM- -IgG antibodies cross placental barrier and cause fetal hemolysisLess severe than Rh incompatibility- primary antibodies of ABO system are IgM and they don’t cross placental barrier-Labs:Nothing specific for mom, not really preventative levels Direct Coombs on baby- test baby’s blood for mom’s antibodies Nursing Assessments:-NewbornCord blood taken to determine blood type of newborn and the antibody titer (Direct Coomb’s test is required)If + ABO then higher risk for jaundice Always know babys blood type Screen for jaundice- not as high risk as Rh- but still possible, check it out No medications involved, no rhogam. No interventions. The Childbearing Family with Special Needs- Ch. 11Learning Objectives/Study Guide-Discuss adverse maternal/fetal and newborn effects of the following substances: -Stimulants including cocaine, amphetamines, and methamphetamines-Opiates including NASSubstance Abuse in Pregnancy Statement:-Tobacco, alcohol & marijuana are the most commonly used substances.Previous placental abruptions, miscarriages, IUGR, -However, the use of opioids, cocaine, and amphetamines have a major impact on healthcare for pregnant women and their offspring.-Drug use during pregnancy can have acute and long-term effects especially on the fetus as they are not able to metabolize the drugs efficiently and can also interfere with normal fetal development and health.Stimulant Substance Abuse•Chemical dependence= physical and psychological dependence on a substance- alcohol, tobacco, or drugs •Whatever mom experiences, the fetus experiences the same systemic effects •Fetus cant metabolize the drugs efficiently- the drug causes intoxication is prolonged in the fetus •Have > impact on the fetus interferes with normal fetal development and health drug use- long term effects on fetus. What are the long term effects- when they are in school and cant keep up-