It is determined that a client's blood Rh is negative and her partner's is positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time?
24 hours before delivery and 24 hours after delivery
In the first trimester and within 2 hours of delivery
At 28 weeks gestation and again within 72 hours after delivery
At 32 weeks gestation and immediately before discharge
The Correct Answer is C
Choice A Reason: This is incorrect because administering Rho(D) immune globulin 24 hours before delivery is too early and may not provide adequate protection for the fetus. Administering it 24 hours after delivery is too late and may not prevent the mother from developing antibodies against the fetal Rh-positive blood cells.
Choice B Reason: This is incorrect because administering Rho(D) immune globulin in the first trimester is unnecessary and may not be effective, as the risk of Rh isoimmunization is very low before 28 weeks of gestation. Administering it within 2 hours of delivery is appropriate, but not sufficient, as it should be repeated within 72 hours after delivery.
Choice C Reason: This is correct because administering Rho(D) immune globulin at 28 weeks gestation and again within 72 hours after delivery is the recommended schedule for preventing Rh isoimmunization in Rh-negative pregnant women who have Rh-positive partners. This regimen can prevent up to 99% of cases of Rh isoimmunization by blocking the maternal immune response to the fetal Rh-positive blood cells.
Choice D Reason: This is incorrect because administering Rho(D) immune globulin at 32 weeks gestation is too late and may not prevent Rh isoimmunization if there has been any fetal-maternal hemorrhage before that time. Administering it immediately before discharge is also too late and may not prevent the mother from developing antibodies against the fetal Rh-positive blood cells.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A: Vitamin E requirements do not decrease during pregnancy due to the increase in body fat. Vitamin E is a fat-soluble vitamin that acts as an antioxidant and protects cell membranes from oxidative damage. The recommended dietary allowance (RDA) for vitamin E during pregnancy is 15 mg/day, which is the same as for non-pregnant women.
Choice B: Prenatal vitamins will meet your need for increased folic acid during pregnancy. Folic acid is a water-soluble vitamin that is essential for DNA synthesis and cell division. Folic acid deficiency can cause neural tube defects in the fetus, such as spina bifida and anencephaly. The RDA for folic acid during pregnancy is 600 mcg/day, which can be obtained from prenatal vitamins and fortified foods.
Choice C: You will not need to double your intake of protein during pregnancy. Protein is a macronutrient that provides amino acids for tissue growth and repair. The RDA for protein during pregnancy is 1.1 g/kg/day, which is only slightly higher than for non-pregnant women (0.8 g/kg/day).
Choice D: You will not need to increase your intake of calcium during pregnancy. Calcium is a mineral that is important for bone health and muscle contraction. Calcium absorption and retention are enhanced during pregnancy, so there is no need to increase the intake above the RDA of 1000 mg/day for women aged 19 to 50 years.
Correct Answer is C
Explanation
Choice A Reason: This is incorrect because gastrointestinal bleeding is not an adverse effect of hydralazine, which is a vasodilator that lowers blood pressure by relaxing the smooth muscles of the blood vessels. Gastrointestinal bleeding can be caused by other conditions such as ulcers, gastritis, or hemorrhoids.
Choice B Reason: This is incorrect because sweating is not an adverse effect of hydralazine, but a normal response to vasodilation and heat loss. Sweating can also be caused by other factors such as fever, anxiety, or exercise.
Choice C Reason: This is correct because tachycardia is an adverse effect of hydralazine, which can occur as a reflex response to vasodilation and hypotension. Tachycardia can increase the cardiac workload and oxygen demand, which can be harmful for pregnant women with preeclampsia who already have impaired placental perfusion and fetal hypoxia.
Choice D Reason: This is incorrect because blurred vision is not an adverse effect of hydralazine, but a symptom of severe preeclampsia that indicates cerebral edema or ischemia. Blurred vision can also be caused by other conditions such as diabetes, glaucoma, or cataracts.
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