A 28-year-old woman is 30 weeks pregnant with her second child and is being seen for a scheduled obstetric visit. Her first pregnancy and delivery was uncomplicated, and she has a healthy 2-year-old girl. It is known that the mother is Rh-, and this child could be at risk for hemolytic disease of the newborn. She received RhoGAM with her first pregnancy.
-After further investigation,it is learned that the father is Rh+,and so was the first child.The patient declines the RhoGAM injection,stating "there were no complications with my first pregnancy and delivery,how can you be sure there will be with this one?" She explains how unpleasant the RhoGAM injection was with her first pregnancy,and she would like to avoid it,if at all possible.What is the most appropriate response by the nurse?

Question

Quizplus · Accepted Answer

The nurse should explain to the patient that it is important to prevent sensitization to Rh factor to avoid future pregnancies being at risk for developing hemolytic disease of the newborn. The nurse should emphasize that the unpleasantness of the injection is temporary, but the consequences of not receiving it could be serious. The fact that the patient received RhoGAM with her first pregnancy does not guarantee that she will not become sensitized during subsequent pregnancies if she is not given the injection. Additionally, the risk of the second child developing hemolytic disease of the newborn is determined by the blood type and Rh factor of both parents, not just the fact that the first child was Rh+.

A 28-Year-Old Woman Is 30 Weeks Pregnant with Her Second