12.08 Rh Immune Globulin (Rhogam)

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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

Reference Links

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Video 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.

Read more

  • Question 1 of 5

The nurse is caring for a pregnant client who has a blood type of A- and needs education for what to expect in her pregnancy. Which of the following should be included in the education?

  • Question 2 of 5

The nurse is caring for a newly pregnant client in the clinic. The client asks about the Rhogam injection that her friend received. The nurse knows that which of the following is true about the client who receives Rhogam?

  • Question 3 of 5

A pregnant client with B- blood could receive rhogam in which of the following situations? Select all that apply.

  • Question 4 of 5

The nurse is caring for a mother with a blood type of O-. Her newborn has a blood type of O+. What do you expect to be part of their plan of care?

  • Question 5 of 5

A student nurse asks the precepting nurse what the role of rhogam is. Which of the following best explains the role of rhogam?

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