Posted: February 11th, 2023

Case Study: A client had an SVD (spontaneous vaginal delivery)

This is a discussion post, please add references
Case Study: A client had an SVD (spontaneous vaginal delivery) today. The labor and delivery nurse gives you a shift report and notes the client is RH Negative and her infant is RH Positive.
Discuss the drug RhoGAM (immune globulin), including:
• Route
• Nursing Implications
• Indications for Use
• Contraindications for Use

RhoGAM (Anti-D Immune Globulin) is a medication given to prevent Rh incompatibility between a mother and her fetus. Rh incompatibility occurs when the mother is Rh negative and the fetus is Rh positive, which can lead to formation of antibodies in the mother's bloodstream against the Rh positive blood cells of the fetus, potentially causing hemolytic disease of the newborn.

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Route: RhoGAM is usually given as an intramuscular (IM) injection in the muscle of the upper arm or the buttocks.

Nursing Implications:

Assess the patient's history and determine the patient's Rh type and antibody status prior to administering RhoGAM
Monitor for any signs of adverse reactions such as swelling, redness, or pain at the injection site, fever, or allergic reaction
Inform the patient of the importance of receiving RhoGAM as a preventive measure, and educate the patient on the purpose, administration, and potential side effects of the drug.
Document the administration of RhoGAM in the patient's medical record, including the dose and route of administration, and any adverse reactions.
Indications for Use: RhoGAM is indicated for use in Rh-negative women who are pregnant or have recently delivered an Rh-positive infant, to prevent the formation of Rh antibodies in the mother's bloodstream.

Contraindications for Use: RhoGAM is contraindicated in patients who have a known hypersensitivity or allergic reaction to any component of the medication. Additionally, RhoGAM should not be used in patients with active systemic infections, as the immune globulin component may worsen the infection.

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References:
"RhoGAM (Anti-D Immune Globulin)." MedlinePlus, U.S. National Library of Medicine, 4 Nov. 2020, medlineplus.gov/druginfo/meds/a601051.html.
"Anti-D (Rho) Immunoglobulin." U.S. National Library of Medicine, PubChem, pubchem.ncbi.nlm.nih.gov/compound/anti-d-rho-immunoglobulin.
"RhoGAM (Anti-D Immune Globulin) in Pregnancy." American Pregnancy Association, americanpregnancy.org/pregnancy-health/rhogam-anti-d-immune-globulin-in-pregnancy/.
"Rh Incompatibility: Understanding the Risks and Prevention." Healthline, 6 Apr. 2020, healthline.com/health/rh-incompatibility.

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