Question

A 2-day-old baby's blood values are:

blood type—O (negative).
direct Coombs—(negative).
hematocrit—50%.
bilirubin—1.5 mg/dL.
The mother's blood type is A . What should the nurse do?
1. Do nothing because the results are within normal limits.
2. Assess the baby for opisthotonic posturing.
3. Administer RhoGAM to the mother per doctor's order.
4. Call the doctor for an order to place the baby under bili-lights.

Answer 1

The nurse should choose to do nothing as the baby has normal hematocrit and bilirubin levels and there is no risk of hemolytic disease of the newborn (HDN) due to the negative Coombs' test and the baby's Rh-negative status.

Step-by-step explanation:

The question addresses the management of a newborn with specific blood values and maternal blood type. Since the baby has a blood type O (negative) and a negative Coombs' test with normal hematocrit and bilirubin levels, the baby is not currently at risk for hemolytic disease of the newborn (HDN). Therefore, the appropriate action for the nurse would be option 1: Do nothing because the results are within normal limits. Additionally, because the mother has an A blood type and the baby has O (negative), there is no ABO incompatibility concern. RhoGAM is administered to Rh-negative mothers who have given birth to an Rh-positive baby to prevent the formation of anti-D antibodies, but in this case, the infant is also Rh-negative, making RhoGAM unnecessary for the mother. This therapy is not relevant to the mother's situation and the normal test results indicate that the baby does not require treatment such as placement under bili-lights.