A laboring client received meperidine IV one hour prior to delivery. Which of the following medications should the nurse have available to counteract the effects of this medication on the newborn?

Choice A rationale:

In Rh incompatibility, if the mother's blood does not contain the Rh factor (Rh-negative) and she is exposed to Rh-positive blood (usually from the fetus during delivery), her immune system may produce anti-Rh antibodies. However, these antibodies do not typically cross the placental barrier during the first pregnancy. Rh incompatibility occurs when the mother's blood is Rh- negative, and she is carrying an Rh-positive fetus during her second or subsequent pregnancies, leading to sensitization and potential hemolysis in future pregnancies.

Choice B rationale:

This choice is correct. Rh incompatibility occurs when the mother is Rh-negative, and the newborn is Rh-positive. During the first pregnancy, the mother is not sensitized to the Rh factor and does not produce significant amounts of anti-Rh antibodies. However, if the fetus is Rh- positive, there is a risk of sensitization during childbirth or any other event where maternal and fetal blood may mix. In subsequent pregnancies, if the mother becomes pregnant with another Rh-positive fetus, her immune system will recognize the Rh antigen as foreign and produce antibodies that can cross the placenta and attack the fetal red blood cells, leading to hemolysis and hyperbilirubinemia in the newborn.

Choice C rationale:

This choice is not related to the mechanism of Rh incompatibility. Receiving a transfusion with Rh-negative blood would not cause the mother's immune system to produce anti-Rh antibodies or lead to Rh incompatibility with her newborn.

Choice D rationale:

This choice describes the ABO blood group system, not the Rh factor. ABO incompatibility can occur when a mother with blood type O (producing anti-A and anti-B antibodies) has a newborn with blood type A, B, or AB, leading to hemolysis of the fetal red blood cells. However, the question specifically mentions Rh incompatibility, which involves the Rh factor, not the ABO system.

Choice A rationale:

This would be incorrect advice. Increasing dietary fiber is commonly recommended during pregnancy to prevent constipation, but it does not address stress incontinence.

Choice B rationale:

This is a correct choice. Kegel exercises are beneficial during pregnancy to strengthen the pelvic floor muscles, which can help manage stress incontinence.

Choice C rationale:

This would be incorrect advice. Restricting daily fluid intake during pregnancy is generally not recommended as it can lead to dehydration and is unlikely to improve stress incontinence.

Choice D rationale:

This is another correct choice. Caffeine is a bladder irritant and can worsen stress incontinence, so reducing caffeine intake can be helpful.

Choice E rationale:

This would be incorrect advice. Regular exercise during pregnancy is generally encouraged unless there are specific medical reasons to avoid it. Avoiding daily exercise is not the appropriate approach to manage stress incontinence.