Page 833 - Saunders Comprehensive Review For NCLEX-RN

syndrome, a grayish brown
discoloration of the skin, a
complication of phototherapy.
l. Reposition the newborn every 2 hours;
monitor the newborn closely.
m. Provide stimulation.
n. If treatment is done at home, teach the
parents about care and indications of
the need to notify the PHCP.
o. After treatment, continue monitoring
for signs of hyperbilirubinemia,
because rebound elevations can occur
after therapy is discontinued.
p. Turn off the phototherapy lights before
drawing a blood specimen for serum
bilirubin levels, and do not leave the
blood specimen uncovered under
fluorescent lights (to prevent the
breakdown of bilirubin in the blood
specimen).
XVIII. Erythroblastosis Fetalis
A. Description
1. Erythroblastosis fetalis is the destruction of red blood
cells that results from an antigen-antibody reaction.
2. The disorder is characterized by hemolytic anemia or
hyperbilirubinemia.
3. Exchange of fetal and maternal blood occurs primarily
when the placenta separates at birth (Fig. 27-5).
4. Antibodies are harmless to the mother but attach to
the erythrocytes in the fetus and cause hemolysis.
5. Sensitization is rare with the first pregnancy and ABO
incompatibility is usually less severe.
B. Assessment
1. Anemia
2. Jaundice that develops rapidly after birth and before
24 hours
3. Edema
C. Interventions

1. Administer Rh (D) immune globulin to the
o
mother during the first 72 hours after birth if the Rh-
negative mother delivers an Rh-positive fetus but
remains unsensitized.
2. Assist with exchange transfusion after birth or
intrauterine transfusion as prescribed.
3. The newborn’s blood is replaced with Rh-negative
blood to stop the destruction of the newborn’s red
blood cells; the Rh-negative blood is replaced with the

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