Chapter 36

Question 1

What causes hemolytic disorders in newborns

Answer 1

Hemolytic disorders occur when maternal antibodies are present naturally or form in response to an antigen from the fetal blood crossing the placenta and entering the maternal circulation.

Question 2

What are the most common causes of hemolytic disease of newborn

Answer 2

ABO Incompatibility – most common
Rh(D) Incompatibility – second most common

Question 3

what is Rh incompatibility

Answer 3

Rh-positive offspring of an Rh-negative mother are at risk
Mother forms antibodies (called maternal sensitization) that then destroy fetal red blood cells (hemolysis)
Results can be mild (fetal jaundice) or severe (Erythroblastosis fetalis, Hydrops fetalis)

Question 4

what is ABO incompatibility

Answer 4

Fetal blood type is A, B, or AB, and the maternal type is O
Naturally occurring anti-A and anti-B antibodies are transferred across the placenta to the fetus
Exchange transfusions required occasionally

Question 5

what is erythroblastosis fetalis

Answer 5

Hemolytic anemia in fetus

Question 6

what is hydrops fetalis

Answer 6

hemolysis that causes large amount of fluid buildup in tissues and organs

Question 7

what is an exchange transfusion

Answer 7

take out blood from neonate and exchange the blood

Question 8

what will be done if mom is rh negative

Answer 8

want to know that in prenatal visits
if pregnancy is normal at around 29 weeks mom will get rhogam shot
normal delivery process, baby will be tested, if baby is rh negative then nothing happens
if baby is positive then give rhogam within 72 hrs after delivery

Question 9

what happens if mom is rh positive

Answer 9

nothing happens

Question 10

what is rh immune globulin

Answer 10

commercial preparation of passive antibodies against the Rh factor; destroys any fetal RBCs in the maternal circulation and blocks the maternal antibody production

Question 11

when is rh immune globulin given

Answer 11

Give to all Rh-negative mothers at 28 weeks of gestation; within 72 hours after delivery & anytime there is a risk of fetal-maternal hemorrhage

Question 12

what are the critical tests for hemolytic disease

Answer 12

indirect Coombs
anti-D titer
MCA-PSV
cord blood at brith
direct Coombs test
serial bilirubin

Question 13

what is the indirect Coombs test

Answer 13

test done on maternal blood, positive, increased risk for hemolytic anemias

Question 14

what is the direct Coombs test

Answer 14

from cord blood, positive coombs means increased risk of jaundice, anemia

Question 15

what causes rhogam to be given

Answer 15

Rhogam is given any time of potential blood crossing
fetal demise, miscarriage, abortion

Question 16

what are the most common congenital anomalies that cause serious issues

Answer 16

Congenital heart disease
Neural tube defects
Cleft lip or palate
Clubfoot
Developmental dysplasia of the hip

Question 17

how much folic acid should be taken daily

Answer 17

400 mcg

Question 18

what are the types of CNS anomalies (neural tube defects

Answer 18

Encephalocele
Anencephaly
Spina Bifida (Occulta, Manifesta)
Meningocele; myelomeningocele
Hydrocephalus
Microcephaly

Question 19

what is an encephalocele

Answer 19

disorder in which the bones of skull do not close completely, which createsa gap where CSF fluid, meninges can protrude in sac like form

Question 20

what is anencephaly

Answer 20

major part , the absense of both cerebral hemispheres and of overlying skull

Question 21

what is spina bifida occulta

Answer 21

milder, laminae failure to close, spinal cord or meninges do not protrude through defect , no abnormality of spinal cord, meninges, or nerve roots

Question 22

what is meningocele

Answer 22

sac may be covered by thin layer of skin , meninges and spinal cord extend thru an irregular vertebrae opening

Question 23

what is a myelomeningocele

Answer 23

no layer of skin covering sac, most common form of spina bifida, spine is exposed

Question 24

what is hydrocephalus

Answer 24

build up of fluid

Question 25

Nursing considerations for myelomeningocele

Answer 25

Covered with moist sterile gauze
surgically corrected,
degree of lower involvement varies
bowel and bladder function might need cath keep covered
do not lay on back
can feed if not having respiratory distress, prevent infection and trauma