RhoGAM

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I need a little refresher on RhoGAM administration.

I know that it needs to e administered at 28 weeks and then again within 72 hours of birth.

But I cannot remember about the Rh factor of the father and Rh factor of the mother?

What about the Coombs test? Does it need to be positive or negative?

Thanks in advance!

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not sure about the Coombs but if the mother is Rh+ Rhogam isn't needed (regardless of the father's blood type) - if the mother is negative and the father positive then Rhogam is administered - if both are negative it isn't.

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Specializes in School Nurse; ICU.

Mother must be RH- and father must be RH+. I do not know about the Coombs test as I was not a nurse for the first 3 and was only a nursing student for the last 2..sorry.

On a side note-that shots HURTS A LOT!!!! It truly feels like concrete being injected into you.

I would advise having the affected? leg (if given in the buttocks) "up" on toes as that seemd to help quite a bit. Also, make sure and stress that they need to keep moving for a while after it has been given. I rode home for about 35 minutes stationary after my first injection (I have had 5) and could hardly get out of the car.

Granted, I was a lot younger and had less of a pain tolerance than I do now but I remember each of those 5 shots very vividly!

Hope this helps

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Specializes in Community, OB, Nursery.

If mom is Rh negative, they should be collecting a cord blood on the baby, which should then be analyzed for type and Rh. If baby comes back Rh neg, then there is no need for postpartum Rhogam. If mom is Rh positive, Rhogam is not necessary, either during pregnancy or after delivery.

We have some docs that will write an order to not give Rhogam, since father and mother are both Rh neg, but if we have a Rh neg mom, we mostly rely on baby's cord blood results. It's noninvasive and accurate.

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and it covers the cases were dad isn't dad......

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Specializes in Nurse Leader specializing in Labor & Delivery.

Yes, we only collect cord blood if it's a "setup" - MOC is Rh negative, or O type.

Coombs measures any kind of incompatibility - it can be Rh or ABO.

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I believe it's a neg Coombs test.

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Specializes in L&D.
I need a little refresher on RhoGAM administration.

I know that it needs to e administered at 28 weeks and then again within 72 hours of birth.

But I cannot remember about the Rh factor of the father and Rh factor of the mother?

What about the Coombs test? Does it need to be positive or negative?

Thanks in advance!

If Mom is Rh neg and Dad is Rh positive, the baby can be either positive or negative. If baby is negative, no RhoGam, if positive, Mom will need RhoGam. The Coombs tells if there is an incompatibility that has started to affect the baby's blood. That incompatibility can be ABO or Rh. RhoGam would be given to an Rh neg mother with an Rh positive baby whether the Coombs was negative or positive.

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and it covers the cases were dad isn't dad......

....and for this reason, that is why we never ask about Dad.

If Mom is negative, Mom gets the shot.

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Specializes in Obstetrics.

In our facility, if mom is RH negative, we send cord blood to blood bank. If it turns out baby is RH positive, we have standing orders to administer Rhogam.

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Specializes in Nurse Leader specializing in Labor & Delivery.
....and for this reason, that is why we never ask about Dad.

If Mom is negative, Mom gets the shot.

Even if the baby is negative too? That's silly and unnecessary. Rhogam is a blood product, and should only be used when absolutely indicated.

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Specializes in NICU, PICU, PACU.

We don't ask where I work because many of our clients don't know for sure whom the father is! But they do check cord blood.

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