The patient indicates to the clinic nurse that she is trying to become pregnant. The clinic nurse reviews the patient's chart and notes the following laboratory values: Blood type O-, RPR nonreactive, rubella non-immune, HCT 35%. Which laboratory value is most concerning to the nurse?

Question

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Rubella non-immune indicates that the patient does not have immunity against rubella and is therefore susceptible to the infection. Exposure to rubella, or German measles, in the first trimester is associated with fetal congenital anomalies. The patient requires a rubella immunization and must not become pregnant within the next 28 days. Although a HCT of 35% is low, women of childbearing age may have mild anemia associated with menstruation. A blood type of O- indicates that the patient will require Rho GAM; however, it is not of concern in the preconception period. A nonreactive RPR indicates that the patient has not been exposed to syphilis.

The Patient Indicates to the Clinic Nurse That She Is