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  • Rh Factor and ABO Incompatibility Objectives: Wong: 617, 619; 736­740; 752­753; 852­854

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    Hyperbilirubinemia n Caused by an excessive level of accumulated bile in the blood n Characterized by jaundice (icterus) signs: decreased activity, loss of Moro reflex, lethargy, irritability, decrease interest in feeding n Survivors may suffer mental retardation,ADHD, delayed / abnormal motor movement, perceptual problems, hearing loss n Sentinel event: Strive to PREVENT!

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    Hyperbilirubinemia n Caused by an excessive level of accumulated bile in the blood n Characterized by jaundice (icterus) signs: decreased activity, loss of Moro reflex, lethargy, irritability, decrease interest in feeding n Survivors may suffer mental retardation,ADHD, delayed / abnormal motor movement, perceptual problems, hearing loss n Sentinel event: Strive to PREVENT!

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    22 visualizzazioni4 pagine

    Rh Factor and ABO Incompatibility Objectives: Wong: 617, 619; 736­740; 752­753; 852­854

    Caricato da

    NL
    Hyperbilirubinemia n Caused by an excessive level of accumulated bile in the blood n Characterized by jaundice (icterus) signs: decreased activity, loss of Moro reflex, lethargy, irritability, decrease interest in feeding n Survivors may suffer mental retardation,ADHD, delayed / abnormal motor movement, perceptual problems, hearing loss n Sentinel event: Strive to PREVENT!

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    Scarica in formato PDF, TXT o leggi online su Scribd
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    di 4

    RhFactorandABO Incompatibility

    Objectives
    n n n n

    Wong:617,619 736740752753 852854.

    DefineRHfactorandABOincompatibility. Identifyrelevantprenatalstudies. Identifys/sassociatedwitheach. Discuscommonmedicaltreatmentsfor motherandinfant:rhogam,exchange transfusion,phototherapy. Recognizeappropriatenursingdiagnosisand developaplanofcareforclientswiththese conditions. Identifyemotionalneedsofpatientand family.

    Hyperbilirubinemia
    n Causedbyanexcessivelevelof

    accumulatedbilirubinintheblood n CharacterizedbyJaundice(icterus) n Mostinstancesisrelativelybenign

    Whyareweconcerned overHyperbilirubinemia?
    n n

    3MajorCategoriesof Jaundice
    PhysiologicJaundice

    Bilirubinencephalopathy(Kernicterus)

    Signs:decreasedactivity,lossofMoro reflex,lethargy,irritability,decreaseinterest infeeding. n Afterseveraldaysrigidextensionof extremities,opisthotonos,fever,seizures, andpossibledeath n Survivorsmaysuffermental retardation,ADHD,delayed/abnormalmotor movement,behaviordisorders,perceptual problems,hearingloss. n Sentinelevent:StrivetoPREVENT!

    BreastFeedingAssociated Jaundice

    Pathological (HemolyticDiseases)

    PhysiologicalJaundice
    n Notassociatedwithpathological

    JaundiceinBreastfed Infants
    n BreastFeedingAssociatedJaundice

    process. n Almostallnewbornshaveincreased bililevelsbutaboutdemonstrate s/s. n Thistypeofjaundicecanoccurdueto differencesininfantsproductionand excretionofRBCs

    (Earlyonset):begins24days.Related toprocessofbreastfeeding. n BreastMilkJaundice(Lateonset): begins57daysandlevelsmayremain highfor312weeks.

    PathologicalJaundice (Hemolytic)
    n n

    ABOIncompatibility
    MaternalBloodGroup IncompatibleFetal BloodGroup O B A AorB AorAB BorAB

    ABOIncompatibility RhIncompatibility

    ABOIncompatibility
    n Occurswhenthemajorbloodgroup

    RhIncompatibility
    n RhpositivePresenceofantigen n RhnegativeAbsenceofantigen n Noproblemswithmotherandfetusif

    antigensofthefetusaredifferent fromthoseofthemother n Mostcommonisbetweenamother with0bloodandtheinfantwithAorB blood n Mayoccurwithfirstpregnancy!

    theyhavethesameRhorifmomis RhpositiveandbabyRhnegative n Undernormalcircumstancesfirstfetus willnotbeharmed.

    RHAntigenFormation

    RhIncompatibility
    nd n 2 pregnancymaternalantibody

    entersfetalcirculation
    n Destructionoffetalerythrocytesoccur n Fetusaccelerateserythropoiesis n Erythroblastsappearinfetalcirculation n Canleadtoerythroblastosisfetalis

    (hydropsfetalis)

    ManagementofJaundice
    n Prevention n Phototherapy n IntrauterineTransfusion n ExchangeTransfusion

    Prevention
    InjectionofRhimmuneglobulin(RhoGAM) within72hourspbirthprevents sensitizationintheRhnegwomanwithRh+ baby. n Adm.Standarddosetomother@28weeks gestationasprophylaxis(paminio, miscarriage/abortion,abd.Trauma..) n ConsideredBloodproductprecautions n Suppressesimmuneresponse n SEEMedicationGuide:page617
    n

    Phototherapy

    Phototherapy (biliblanket)

    Intrauterine/Exchange Transfusions
    Intrauterine transfusion: canbedone every2weeks untilPulm maturity n Exchange transfusion: about7585%of bloodexchanged pbabydelivered
    n

    Prenatal PostPartum n Discharge/Home


    n n

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