Rhogam question

[ccahill]

I recently gave a Rhogam shot to a pregnant patient. I am worried I gave the shot to high on the backside. She said it burned a little going in, but I know that is a normal reaction to this medication. Will the medication still have the desired effect? No harm to the mom or baby? Am I just freaking out because I am a new graduate nurse at my first job? Any advice would be much appreciated!

[klone, MSN, RN]

It will probably be fine. Was the injection in the gluteus, or ventro-gluteal? If it was gluteal, the best way to do it is look at the whole buttock, divide it into four quadrants, and give the injection in the upper, outer quadrant.

[ccahill]

It was in the gluteal, thanks for the reassurance! The mother was a young mom, G1. Does that make a difference? Also why is it given gluteal, I've read online some give it in the arm? Is any IM location acceptable or is one preferable?

[klone, MSN, RN]

I would never give it in the arm. It's a thick solution, and is usually quite painful. It would be even more so if giving in the deltoid.

[Lisa_E]

I recently attended a conference where it was stated that Rhogam is shown to be more effective if given in the deltoid. I haven't researched it any further but found that interesting.

[ccahill]

Did they say why it was more effective? My thinking, gluteal is a bigger muscle, better absorption. No?

[klone, MSN, RN]

Have you ever seen a woman who developed Rh isoimmunization when she has received Rhogam appropriately? I haven't, so it would seem to me that it's effective, even when given in the glute.

[Lisa_E]

She didn't elaborate - it was mentioned in the midst of a discussion on another topic. As I said, I haven't researched it further, I just found it interesting. It was an Advanced Fetal Monitoring class by Lisa Miller.