A nurse is caring for a client who is 6 hours postpartum. The client is Rh-negative and her newborn is Rh-positive. The client asks why an indirect Coombs test was ordered by the provider. Which of the following is an appropriate response by the nurse?
"It detects positive antibodies in the mother's blood."
"It detects Rh-negative antibodies in the newborn's blood."
"It determines if kernicterus will occur in the newborn."
"It determines the presence of maternal antibodies in the newborn's blood."
The Correct Answer is A
Choice A reason: The indirect Coombs test is used to screen for antibodies in the mother's blood that could potentially cause hemolytic disease in the newborn if they are Rh-positive. A positive result indicates that the mother has developed antibodies that could cross the placenta and attack the red blood cells of an Rh-positive fetus.
Choice B reason: The indirect Coombs test does not detect Rh-negative antibodies in the newborn's blood. Instead, it is used to detect antibodies in the mother's blood. The direct Coombs test is used to detect antibodies that are already attached to the red blood cells of the newborn.
Choice C reason: The indirect Coombs test does not determine if kernicterus will occur in the newborn. Kernicterus is a form of brain damage that can result from very high levels of bilirubin in a baby's blood. It is not directly related to the presence of antibodies detected by the indirect Coombs test.
Choice D reason: The indirect Coombs test does not determine the presence of maternal antibodies in the newborn's blood. This is assessed by the direct Coombs test, which checks for antibodies bound to the surface of the newborn's red blood cells, indicating that the immune system is attacking them.
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Related Questions
Correct Answer is D
Explanation
Choice a reason:
Monitoring the heart rate is important for any newborn, but it is not the priority intervention for an SGA newborn. SGA newborns are at risk for several complications, but abnormal heart rates are not a primary concern directly related to being small for gestational age.
Choice b reason:
While monitoring weight is a part of routine newborn care and important for tracking growth and development, it is not the most immediate concern for an SGA newborn. The priority is to address potential acute complications that can arise from being small for gestational age.
Choice c reason:
Monitoring axillary temperature is important for maintaining normothermia in newborns, especially those who are SGA, as they have less subcutaneous fat and are more prone to heat loss. However, the most critical and immediate risk for SGA newborns is hypoglycemia, making blood glucose monitoring a higher priority.
Choice d reason:
SGA newborns are at increased risk for hypoglycemia due to their decreased glycogen stores. Therefore, monitoring blood glucose levels is a priority intervention. Hypoglycemia can lead to serious complications such as seizures and brain injury if not promptly identified and treated. It is essential to monitor blood glucose levels frequently and intervene as necessary to maintain them within a normal range.
Correct Answer is ["0504"]
Explanation
To calculate the estimated date of birth (EDB), also known as the due date, we use Naegele's Rule, which involves adding one year, subtracting three months, and adding seven days to the first day of the last menstrual period (LMP). Using this rule, if the LMP was on July 27, the EDB would be:
- Add one year: July 27, 2024
- Subtract three months: April 27, 2024
- Add seven days: May 4, 2024
Therefore, the EDB in MMDD format is 0504.
Reason:
Naegele's Rule is a standard way of calculating the due date for a pregnancy. The rule estimates the expected date of delivery (EDD) by adding one year, subtracting three months, and adding seven days to the date of a woman's last menstrual period (LMP). This calculation assumes a regular menstrual cycle of 28 days and ovulation occurring on the 14th day of the cycle. The EDB is typically set at 40 weeks from the LMP, which is approximately 280 days. While this method provides an estimate, only about 4% of births occur on the exact due date, and most births occur within a range of two weeks before or after the estimated due date.
It's important to note that the EDB is an estimate and can be influenced by factors such as the length of menstrual cycles, the exact day of ovulation, and the date of conception. Ultrasounds and other prenatal tests can provide additional information to refine the due date estimate as the pregnancy progresses.
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