Final answer:
The nurse would identify an Rh- client who conceived with an Rh+ partner and gave birth 3 years ago to an Rh+ infant as the most likely to have a problem with Rh incompatibility with the fetus. In subsequent pregnancies, the mother's anti-Rh antibodies can cross the placenta and attack the RBCs of an Rh+ fetus, causing hemolytic disease of the newborn (HDN). To prevent HDN, the mother should receive Rho(D) immune globulin treatment during the first pregnancy with an Rh+ fetus.
Step-by-step explanation:
The nurse would identify option b- an Rh- client who conceived with an Rh+ partner and have birth 3 years ago to an Rh+ infant as the most likely to have a problem with Rh incompatibility with the fetus.
During the first pregnancy, the Rh- mother is usually not sensitized and does not produce anti-Rh antibodies. However, after the birth of an Rh+ infant, the mother's immune system may generate anti-Rh antibodies, which can cross the placenta and attack the RBCs of an Rh+ fetus in subsequent pregnancies, causing hemolytic disease of the newborn (HDN).
To prevent HDN caused by Rh incompatibility, the mother should receive Rho(D) immune globulin (e.g., RhoGAM) treatment during the first pregnancy with an Rh+ fetus.