Final answer:
A nurse should verify that the Coombs' test results are negative before administering RhoGAM to a postpartum woman to prevent sensitization and future risks of HDN. The drug is indicated for Rh-negative mothers and should be administered within 72 hours following birth, regardless of prior pregnancy treatment.
Step-by-step explanation:
Administering RhoGAM in Postpartum Care
When preparing to administer RhoGAM to a postpartum woman, a nurse should verify that the Coombs' test results are negative. This is crucial as RhoGAM is a preventive treatment against hemolytic disease of the newborn (HDN), and its administration is indicated for Rh-negative mothers who may potentially carry Rh antibodies due to exposure to Rh-positive fetal blood. If a Coombs' test is negative, it indicates that the mother has not formed antibodies against Rh-positive blood, making the administration of RhoGAM appropriate to prevent sensitization that could affect future pregnancies.
RhoGAM is typically administered during the 26-28 week period of pregnancy and within 72 hours following birth, regardless of whether it was given during pregnancy. It works by destroying any fetal Rh-positive erythrocytes that may have crossed the placental barrier, preventing the development of Rh antibodies in the mother. Since the introduction of RhoGAM, the incidence of HDN in the United States has plummeted from around 13-14 percent to about 0.1 percent.
Ensuring the newborn is Rh-negative (option c) is not a necessary condition for RhoGAM administration, as it is intended for the protection of the Rh-negative mother to prevent future HDN risks. The administration of RhoGAM should not be canceled if it was given during pregnancy at 28 weeks of gestation (option d), as a postpartum dose is still needed to cover any fetal blood exposure during delivery.