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    Obstetricspediatrics proctored exam

    A patient is a gravida 1. Rh-negative woman at a 28 weeks gestation. The father of her child is Rh- positive. The mother is asking the nurse about the effect on her unborn child of RhoGAM that has been ordered. What is the nurse's best reply?

    Explanation & Rationale

    A. "Your child will do well after birth once transfusions are administered": This statement focuses on postnatal intervention rather than preventing maternal sensitization during pregnancy, which is the primary purpose of RhoGAM. B. "RhoGAM kills antibodies you make, so your kid will be protected": RhoGAM does not destroy existing antibodies; it prevents the formation of maternal antibodies against Rh-positive fetal cells. This explanation could mislead the patient. C. "Your baby may be Rh positive and cause you to make antibodies. These won't affect this baby, but could affect future children if RhoGAM isn't given": RhoGAM prevents maternal sensitization by neutralizing fetal Rh-positive red blood cells before the immune system responds. This explanation clearly communicates the purpose of the medication and the relevance for future pregnancies. D. "If the baby is Rh negative at birth, he or she will need RhoGAM also": RhoGAM is administered to the mother, not the baby, and is only necessary if the mother is Rh-negative and the fetus is Rh-positive.

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