A nurse is caring for a pregnant client at 27 weeks gestation after a motor vehicle collision with side airbag deployment. The client's blood type is O negative. Which laboratory test should the nurse anticipate?

Question

A nurse is caring for a pregnant client at 27 weeks gestation after a motor vehicle collision with side airbag deployment.  The client's blood type is O negative.  Which laboratory test should the nurse anticipate?

Quizplus · Accepted Answer

11ecbb05_cbf5_8b4b_b433_af3af41615dc_MD0009_00 During pregnancy, the mother and fetus have separate blood supply mechanisms. However, disruption of this separation can occur at delivery or when trauma results in fetomaternal hemorrhage (eg, placental abruption after a motor vehicle collision). If an Rh-negative mother (eg, O negative blood type) is exposed to Rh-positive fetal blood (if the father is Rh positive), the pregnant client develops antibodies to the Rh antigen (ie, Rh sensitization), placing the current fetus and all future pregnancies at risk for serious complications (eg, hemolytic anemia). An indirect Coombs test is performed to screen for Rh sensitization any time hemorrhage secondary to placental abruption is suspected (eg, maternal trauma) (Option B). Rh immune globulin (eg, RhoGAM) is administered to all Rh-negative pregnant clients at 28 weeks gestation and within 72 hours postpartum, as well as after any maternal trauma, to prevent the development of permanent Rh antibodies. RhoGAM is not effective once sensitization has occurred. (Option A) Perineal group B streptococcal cultures are routinely obtained at 35-37 weeks gestation to determine the need for antibiotics during labor to prevent neonatal infection. (Option C) Testing for rubella immunity is performed in the first trimester; nonimmune mothers receive the measles-mumps-rubella vaccine in the immediate postpartum period. (Option D) Serum alpha-fetoprotein is a blood test to screen for fetal neural tube defects. Educational objective: Indirect Coombs testing screens for Rh sensitization in Rh-negative mothers. If the test results are positive, the fetus and subsequent pregnancies are at risk for serious complications. Rh immune globulin (eg, RhoGAM) is given at 28 weeks gestation and within 72 hours postpartum as well as any time there is maternal trauma.

A Nurse Is Caring for a Pregnant Client at 27