Rh Immune Globulin (Rhogam)

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Study Tools For Rh Immune Globulin (Rhogam)

OB Medications (Cheatsheet)
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Outline

Overview

  1. Indication
    1. Given during pregnancy to prevent the Rh negative mother from developing antibodies against the fetus
    2. Given after delivery to prevent the Rh negative mother from developing antibodies that could attack a future pregnancy

Nursing Points

General

  1. Given to moms at 28 weeks and with in 72 hours of delivery
  2. Given to moms anytime there is a possibility blood mixture has occurred
    1. Pregnancy loss
    2. Ectopic pregnancy
    3. Injury to abdomen
      1. Fall
      2. Car accident
  3. IM injection
  4. See Lesson on Erythroblastosis Fetalis.

Assessment

  1. Verify Rh status of mother
    1. Only given to Rh negative patients
  2. Verify Rh status of newborn at delivery
    1. Cord blood
    2. Rh positive→ mother will receive Rhogam

Therapeutic Management

  1. Rhogam studies after delivery
  2. Rhogam given within 72 hours of delivery
    1. This is a blood product

Nursing Concepts

  1. Pharmacology
  2. Reproduction

Patient Education

  1. Why she is receiving
  2. IM injection

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Transcript

In this lesson I will explain Rh immune globulin and when it is given as well as your role in this care.

Ok let’s look at what this medication is. It is known as Rhogam. First let’s talk about what it is for. So we have learned that there are blood types that are incompatible. When blood types are not compatible the body makes antibodies. So this is given to a mother that has a Rh negative blood type to protect the fetus from making antibodies against maternal blood and to prevent the mother from making antibodies that would attack fetal blood. This will also be given to protect future pregnancies from being attacked by the maternal immune system. So when do we give it? It is given a few times. It is given at 28 weeks and then within 72 hours of delivery IF the newborn is Rh positive. If the newborn is negative then she doesn’t get it again. The mother will also be given this medication anytime there is a risk that blood mixture has occurred. So this would be in the event that there was a pregnancy loss, ectopic pregnancy or if there been trauma to the abdomen like a car accident or fall on the belly.

Our assessment is going to be to verify the Rh status of mother. Remember it is only given to Rh negative patients. We also will verify Rh status of newborn at delivery. Cord blood will be taken and if the newborn is Rh positive then the mother will receive Rhogam. If the newborn is negative then nothing further is needed. Management will be to draw rhogam studies on the patient the night after delivery if the newborn has been identified as positive. Remember its a blood product and the blood bank will need to get the right type so that is what the studies are for. We also just be to prepare patient and make her comfortable and this is an IM injection and a lot of medication so best to not give in the arm and do a big muscle group like the thigh.

Education will revolve on explaining why and what we are doing for the patient and letting her know where we will be injecting it.

Pharmacology is a concept because its medication and reproduction because this is needed to protect future pregnancies.

Ok so let’s review everything now. Rhogam is a blood product and it is is given to a mother that is Rh negative at 28 weeks, It is give again within 72 hours after delivery if the newborn is Rh positive. It is also given anytime there is a blood mixture. It is going to protect the moher from producing antibodies as that would cause an incompatibility if blood exposure occurs and also to protect a future pregnancy from being attacked by the maternal immune system.

Make sure you check out the resources attached to this lesson and review those key points. Now, go out and be your best selves today. And, as always, happy nursing.

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Maternal Fetal Medicine

Concepts Covered:

  • Labor Complications
  • Pregnancy Risks
  • Newborn Care
  • Postpartum Care
  • Postpartum Complications
  • Prenatal Concepts
  • Fetal Development
  • Newborn Complications
  • Labor and Delivery
  • Studying
  • Medication Administration

Study Plan Lessons

Abruptio Placenta for Certified Emergency Nursing (CEN)
Abruptio Placentae (Placental abruption)
Anemia in Pregnancy
Antepartum Testing
Babies by Term
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone in Pregnancy
Breastfeeding
Cardiac (Heart) Disease in Pregnancy
Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)
Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)
Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)
Certified Nurse Midwife
Day in the Life of a Labor Nurse
Day in the Life of a Postpartum Nurse
Discomforts of Pregnancy
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Ectopic Pregnancy
Ectopic Pregnancy for Certified Emergency Nursing (CEN)
Emergent Delivery (OB) (30 min)
Emergent Delivery for Certified Emergency Nursing (CEN)
Epidural
Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)
Erythroblastosis Fetalis
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Fertilization and Implantation
Fetal Alcohol Syndrome (FAS)
Fetal Development
Fetal Heart Monitoring (FHM)
Fetal Heart Monitoring Like A Pro – Live Tutoring Archive
Fetal Heart Monitoring Like A Pro 2 – Live Tutoring Archive
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fundal Height Assessment for Nurses
Gestation & Nägele’s Rule: Estimating Due Dates
Gestational Diabetes (GDM)
Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive
Gestational HTN (Hypertension)
Gravidity and Parity (G&Ps, GTPAL)
Glucose Tolerance Test (GTT) Lab Values
Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)
Infections in Pregnancy
Incompetent Cervix
Initial Care of the Newborn (APGAR)
Labor Progression Case Study (45 min)
Magnesium Sulfate in Pregnancy
Mastitis
Maternal Risk Factors
Mechanisms of Labor
Meconium Aspiration
Meds for Postpartum Hemorrhage (PPH)
Meds for PPH (postpartum hemorrhage)
Menstrual Cycle
Newborn of HIV+ Mother
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Chorioamnionitis
Nursing Care Plan (NCP) for Ectopic Pregnancy
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for Gestational Diabetes (GDM)
Nursing Care Plan (NCP) for Hyperemesis Gravidarum
Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL
Nursing Care Plan (NCP) for Process of Labor
Oxytocin (Pitocin) Nursing Considerations
Placenta Previa
Placenta Previa for Certified Emergency Nursing (CEN)
Postpartum Discomforts
Postpartum Hemorrhage (PPH)
Postpartum Interventions
Postpartum Thrombophlebitis
Preeclampsia (45 min)
Preeclampsia, Eclampsia, and HELLP Syndrome for Certified Emergency Nursing (CEN)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Pregnancy Labs
Premature Rupture of the Membranes (PROM)
Preterm Labor
Preterm Labor for Certified Emergency Nursing (CEN)
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Prostaglandins in Pregnancy
Rh Immune Globulin (Rhogam)
Rh Immune Globulin in Pregnancy
Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)