Rhogam is not effective if she is already sensitized What can happen Hemolysis

Rhogam is not effective if she is already sensitized

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Rhogam is not effective if she is already sensitized What can happen? Hemolysis
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Nursing assessments: - Maternal Labs Titer- (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. - Newborn Hemolysis jaundice Direct coombs- if pos, check bili level bili light and treatment Optical density- amount of bilirubin present in amniotic fluid US- evaluation of fetus Doppler studies for cardiac function and blood flow in vessels If 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 hemolysis Less 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: - Newborn Cord 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. 11 Learning Objectives/Study Guide - Discuss adverse maternal/fetal and newborn effects of the following substances: - Stimulants including cocaine, amphetamines, and methamphetamines - Opiates including NAS Substance 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-
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