Rh Immune Globulin in Pregnancy

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Study Tools For Rh Immune Globulin in Pregnancy

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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OB

Concepts Covered:

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

Study Plan Lessons

Abortion in Nursing: Spontaneous, Induced, and Missed
Abruptio Placentae (Placental abruption)
Acyclovir (Zovirax) Nursing Considerations
Addicted Newborn
Alpha-fetoprotein (AFP) Lab Values
Anemia in Pregnancy
Antepartum Testing
Antepartum Testing Case Study (45 min)
Babies by Term
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone in Pregnancy
Breastfeeding
Butorphanol (Stadol) Nursing Considerations
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)
Chorioamnionitis
Day in the Life of a Labor Nurse
Day in the Life of a Postpartum Nurse
Discomforts of Pregnancy
Disseminated Intravascular Coagulation (DIC)
Dystocia
Ectopic Pregnancy
Ectopic Pregnancy Case Study (30 min)
Emergent Delivery (OB) (30 min)
Epidural
Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)
Erythroblastosis Fetalis
Eye Prophylaxis for Newborn
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Family Planning & Contraception
Fertilization and Implantation
Fetal Alcohol Syndrome (FAS)
Fetal Circulation
Fetal Development
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Heart Monitoring (FHM)
Fetal Environment
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fundal Height Assessment for Nurses
Gestation & Nägele’s Rule: Estimating Due Dates
Gestational Diabetes (GDM)
Gestational HTN (Hypertension)
Glucose Tolerance Test (GTT) Lab Values
Gravidity and Parity (G&Ps, GTPAL)
HELLP Syndrome
HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)
Hepatitis B Vaccine for Newborns
Homocysteine (HCY) Lab Values
Hydatidiform Mole (Molar pregnancy)
Hyperemesis Gravidarum
Hypovolemic Shock Case Study (OB sim) (60 min)
Incompetent Cervix
Infections in Pregnancy
Initial Care of the Newborn (APGAR)
Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)
Labor Progression Case Study (45 min)
Leopold Maneuvers
Lung Surfactant for Newborns
Magnesium Sulfate (MgSO4) Nursing Considerations
Magnesium Sulfate in Pregnancy
Mastitis
Maternal Risk Factors
Mechanisms of Labor
Meconium Aspiration
Meds for Postpartum Hemorrhage (PPH)
Menstrual Cycle
Newborn of HIV+ Mother
Newborn Physical Exam
Newborn Reflexes
Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Chorioamnionitis
Nursing Care Plan (NCP) for Dystocia
Nursing Care Plan (NCP) for Ectopic Pregnancy
Nursing Care Plan (NCP) for Gestational Diabetes (GDM)
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for Hyperemesis Gravidarum
Nursing Care Plan (NCP) for Incompetent Cervix
Nursing Care Plan (NCP) for Mastitis
Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL
Nursing Care Plan (NCP) for Meconium Aspiration
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Newborns
Nursing Care Plan (NCP) for Placenta Previa
Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)
Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)
Nursing Care Plan (NCP) for Preterm Labor / Premature Labor
Nursing Care Plan (NCP) for Process of Labor
Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)
Nursing Care Plan (NCP) for Transient Tachypnea of Newborn
Nursing Case Study for Maternal Newborn
Nutrition in Pregnancy
OB (Labor) Nurse Report to OB (Postpartum) Nurses
OB Non-Stress Test Results Nursing Mnemonic (NNN)
Obstetric Trauma for Certified Emergency Nursing (CEN)
Obstetrical Procedures
Opioid Analgesics in Pregnancy
Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)
Oxytocin (Pitocin) Nursing Considerations
Pediatric Vital Signs (VS)
Phytonadione (Vitamin K) for Newborn
Placenta Previa for Certified Emergency Nursing (CEN)
Possible Infections During Pregnancy Nursing Mnemonic (TORCH)
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Postpartum Discomforts
Postpartum Hematoma
Postpartum Interventions
Postpartum Physiological Maternal Changes
Preeclampsia (45 min)
Postpartum Thrombophlebitis
Precipitous Labor
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Pregnancy Labs
Pregnancy Outcomes Nursing Mnemonic (GTPAL)
Preterm Labor for Certified Emergency Nursing (CEN)
Process of Labor – Mom Nursing Mnemonic (4 P’s)
Process of Labor – Baby Nursing Mnemonic (ALPPPS)
Prolapsed Umbilical Cord
Prostaglandins in Pregnancy
Rh Immune Globulin in Pregnancy
Signs of Pregnancy (Presumptive, Probable, Positive)
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Tips & Advice for Newborns (Neonatal IV Insertion)
Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)
Tocolytics
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)