1. If you have a negative titer indicating susceptibility to rubella virus, then you must receive the appropriate immunization postpartum.

    What must you teach this patient regarding rubella immunization?
    You should not get pregnant for 1-3 months following immunization

    You also should not be near anyone that is immunocompromised

    If rubella vaccine is administered at the same time as Rh immunoglobulin, it might not be effective.
  2. If client is Rh negative and has a negative antibody screen, she will need to do what?

    When can she receive her Rh immune globlulin?
    She needs to repeat antibody screens and should receive Rh immune globulin at 28 weeks
  3. Alpha-fetoprotein screening
    1.Increased level of protein is associated with what anomalies?
    2. What can it detect (specifically what dz?)
    3. How is it performed and what proceeds if it's elevated?
    • 1. neural tube and abdominal wall defects.
    • 2. spina bifida and Down syndrome
    • 3. Maternal blood sample is drawn at 15-18 weeks gestation. If elevated, 2nd sample is drawn (if gestation is less than 18 weeks). U/S is performed for elevated levels to r/o abnormalities or multiple gstation.
  4. Chorionic villus sampling
    1. How & when is it performed?
    2. What is the purpose?
    3. What are some important interventions before procedure?
    • 1. Small sample of chorionic villus tissue at 8-12 weeks gestation
    • 2. Detect genetic abnormalities
    • 3. Instruct client to DRINK WATER to fill the bladder before the procedure to aid the visualization of the uterus for catheter insertion.
    • Rh neg women may be given RhoGAM since this procedure can incrase risk of Rh sensitzation
  5. Amniocentesis
    1. What is the purpose?
    2. When is it performed?
    3. Since there's a risk of PROM, what should the nurse instruct the patient to do post-procedure?
    • 1. To determine genetic d.o, metabolic defects, and fetal lung maturity
    • 2. 13-14 weeks
    • 3. Nurse need to obtain baseline and FHR then monitor q15min. Instruct client that if chills, fever, leakage of fluid at needle insertion site, or decreased FHR and increased contractions occur, need to notify physician!
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