a nurse is caring for a client who is at 15 weeks of gestation is rh-negative This is a topic that many people are looking for. g4site.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, g4site.com would like to introduce to you Rh Incompatibility in Pregnancy Nursing NCLEX Management | Rhogam Shot Maternity Review. Following along are instructions in the video below:
Is cereth registered nurse rn calm and in this video. Im going to be be going over rh incompatibility in this video. Is part of an ink lex review over maternity nursing.
So lets get started first lets start out. Talking about what is rh and compatibility. Well.
This is where you have a mother who is rh negative. And shes carrying a baby. That is rh positive.
And what happens is usually at the end of the pregnancy. Whenever. Its time to deliver the baby.
The blood from the baby will mix into mothers circulation and this will cause moms body to create these antibodies. Because whenever this rh positive blood got into mamas system whos rh negative. The body sees that i was like a foreign invader and its like oh.
Weve got to create these antibodies. So next time we see this we cant attack. And thats just what it does during the second pregnancy.
Whenever mom gets pregnant again and she carries an rh positive baby. So what happens these antibodies get in there and they attack the baby causing severe anemia heart failure and jaundice which were gonna be going depth about the path. Oh.
And whats happening to the child and the prevention and the nursing care here in a moment. But first lets talk about red blood cells okay in our blood typing video. We learned about the various blood types you can have a you can have b.
Youve got a b or oh. And based on whatever type you are lets say your type a you have a antigens on your red blood cell surface youre type b. You have b antigens on that surface and then so forth.
We also learned that on the red blood cell. A person can either have it or they dont a special protein called rh factor. So if a person has these little special protein factors on here what are they known as theyre known as rh positive okay.
But if they dont have these factors theyre absent on that red blood cell surface theyre known as rh negative. And thats what were talking about here. Our mother.
Doesnt have these proteins present on her red blood cell surface and heres the thing. If youre rh positive. You can easily receive positive or negative factor blood without any problems no antibodies being created however if youre rh negative.
You can only receive other rh negative blood you cant receive positive because if you did youll create these antibodies that will actually attack those red blood cells. And that is really whats going on here in this whole condition so now lets talk about how this happened okay. We have a father.
He is rh positive. So he has these proteins present on his red blood cell surface then we have a mother who is rh negative. She doesnt have these proteins now.
Its a really high probability that theyre gonna have a baby that is rh positive. But lets say that they didnt it was an rh negative. Baby everythings fine cuz remember momma can receive other rh negative blood into her system but she cant receive positive rh factor blood in her system or lets say that the father was rh negative.
Mom is rh negative. Thats fine or if father was rh negative. And mama was rh positive thats fine because like i said the beginning.
The lecture mom can receive positive and negative blood. So baby was negative. It would be okay now typically in the first pregnancy.
The baby is not affected because this happens. These antibodies are created once that baby is delivered when that placenta comes off of the wall the blood from the baby will go into mamas circulation. The body will see that rh positive blood and say were not gonna have any of that thats a foreign invader and creates these antibodies.
So babys gone by the time. These antibodies are really formed and ready to attack if they see rh positive blood again. However sometimes this can happen early on where babys blood enters into moms circulation like with a trauma like abruptio placentae.
Where some of that placenta has came off the uterine wall either partially or totally babys blood goes into mom. So. Halation antibodies are created babys still in there.
And those antibodies can attack or like with an invasive procedure. Like an amniocentesis or whatever the patient can have where the bloods going to pass over now the thing is is whatever that happens once that rh positive blood gets into this mamas blood thats rh negative. The mama has become sensitized to it and as healthcare professionals.
We want to prevent that which is why its important we give rhogam and we test them on this blood type early on and those prenatal visits to see what she is which were going to really jump into here in a moment. So now lets look at this second pregnancy. Okay mom is now sensitized she became sensitized over here in that first pregnancy she has all these antibodies in her system that are on the lookout for red blood cells with positive rh factor.
Because they seen them before and next time they see it theyre going to attack. So we have again or rh positive father rh negative. Mother real high probability.
Theyre gonna have another rh positive child. But by chance if they have an rh negative child. This isnt going to happen.
Its just with the baby whos rh positive. So here we have these antibodies and a neat thing. That occurs during pregnancy.
Naturally is called passive immunity. Its where mama is passing some of her antibodies that shes built up over the years to help that child survive once. Its born from oven bacterium viruses that are naturally in our environment.
But also whats getting passed to this child are these antibodies that she created over here and these antibodies again their goal is to attack red blood cells with rh factor. Thats on them so it senses that it sees these red blood cells. Its like foreign invader attacks.
So its going to attack the babys red blood cells. Whatever whenever that happens these red blood cells are going to hemolysis which is going to draw the count of red blood cells in the babys body now whenever that happens what do red blood cells. Do they help transport oxygen throughout the body which this child really means that but thats not going to really occur because were losing the four of them because those antibodies are attacking those red blood cells.
This is going to cause severe anemia in this child now when anemia happens. What organ is really going to be affected that heart because the heart pumps blood throughout the body to give that oxygenated blood it just received from the lungs to the organs to the tissues and its going to sense that those oxygen levels have dropped because theres no red blood cells to carry that oxygen and so its going to try to step up its game its going to pump harder its gonna pump faster trying to get it there but it can only do this for so long and it starts to wear out whenever that happens. The baby will enter into heart failure.
And when the heart muscles weak cant pump fluid start building up and we get a really big problem so thats why youre gonna see a deema swelling throughout in addition from where those red blood cells are breaking open from where you have the breakdown of red blood cells thats going to leak billy reuben into the blood and we dont want it there and the liver cant even conjugate it fast enough because the liver and the spleen are busy trying to make more red blood cells. And thats going to overwork those organs youre going to get a splinter megali increase in the size of the spleen and heap at a mega ly increasing the size of the liver and these red blood cells that theyre going to produce really dont do much of anything theyre going to be immature and theyre too small to really help this child out. So.
The baby is going to experience jaundice. Because of all that bilirubin thats going to be in the blood. And bilirubin is really a neurotoxic agent and its not meant like i said to be in the blood.
And it can really affect the brain development of the baby. So the baby can have neuro issues as well if they have too much bilirubin in their system. So as the nurse really the whole key and preventing this from happening is preventing this mom from becoming sensitized.
We want to prevent that so what do we do well during that prenatal period. Were going to look at there type and look at their rh factor and if theyre a negative b negative a b negative or a negative throwing to receive a rhogam shot and its given. I am intramuscularly and the woman will receive it at 28 weeks and after delivery.
If her baby is indeed rh positive. They will test that and shell need to get that other shot within 72 hours after delivery and how does rhogam work. What does it do well.
What it does is it softs immune system from creating those antibodies. So when that blood from that rh positive. Baby enters into the circulation.
This rhogam. Which is already on board will prevent that immune system from creating those antibodies. So moms not going to become sensitized.
Now rhogam is not effective. If moms already been sensitized. She already has those antibodies present.
So it wont really work now. Its really important that rhodium is given with each pregnancy to prevent mom from becoming sensitized okay so that wraps up this lecture on rh incompatibility thank you so much for watching and dont forget to subscribe to our channel for more videos. .
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