NIMHANS Nursing Officer - 2019
Obstetrics & Gynaecology
Easy
RhoGAM (Anti D) dose after delivery is?
Appeared in: NIMHANS Nursing Officer - 2019
Explanation
- The standard postpartum dose of Rho(D) immune globulin is 300 micrograms (mcg).
- This dose is equivalent to 1500 International Units (IU).
- It is administered to an Rh-negative mother within 72 hours of delivering an Rh-positive baby.
- This dose is calculated to neutralize up to 30 mL of fetal whole blood that may have entered the maternal circulation, preventing maternal antibody formation.
Why Other Options Were Wrong
- Option A: The microgram (mcg) value is incorrect. While 1500 IU is the correct unit equivalent for a standard dose, it corresponds to 300 mcg, not 500 mcg.
- Option C: The International Unit (IU) value is incorrect. A standard 300 mcg dose is equivalent to 1500 IU, not 500 IU. A 500 IU dose (equivalent to 100 mcg) might be used for first-trimester events, but not for routine postpartum prophylaxis.
- Option D: This option presents a critical and dangerous dosage error. A milligram (mg) is 1000 times larger than a microgram (mcg). Administering 300 mg would be a massive overdose.
Related Visual
Clinical Relevance
- Nursing practice connection: Safe nursing care depends on performing The concept tested is the correct dosage and administration of Rho(D) immune globulin (RhoGAM) in the postpartum period to prevent Rh isoimmunization in the correct sequence, documenting the action clearly, and monitoring for the expected response.
- Administering the correct dose of RhoGAM is critical to prevent Rh isoimmunization, which can cause Hemolytic Disease of the Fetus and Newborn (HDFN) in future pregnancies. HDFN can lead to severe fetal anemia, hydrops fetalis, and even fetal death.
- Nurses must meticulously verify the mother's Rh status, the newborn's Rh status, and the correct drug, dose, and units (mcg vs. mg) before administration.
- What if? If a massive fetomaternal hemorrhage is suspected (e.g., due to placental abruption or traumatic delivery), a single 300 mcg dose is insufficient. The nurse should anticipate an order for a Kleihauer-Betke (KB) test to quantify the bleed and calculate the number of additional RhoGAM vials required.
How to Approach the Question
- First, identify the core of the question: the standard postpartum dose of RhoGAM (Anti-D).
- Recall the purpose of RhoGAM: to prevent Rh sensitization in an Rh-negative mother with an Rh-positive baby.
- Access your knowledge of standard medication dosages in obstetrics. The postpartum dose is a common fact to memorize.
- Carefully examine each option, paying close attention to both the numerical value and the units (mcg vs. mg) and the IU equivalent.
- Eliminate options with incorrect numerical values or mismatched units. Recognize that 300 mg is a dangerously incorrect dose compared to 300 mcg.
- Confirm that 300 mcg is equivalent to 1500 IU to select the correct option.
Concept Tested & Keywords
- Concept Tested: The concept tested is the correct dosage and administration of Rho(D) immune globulin (RhoGAM) in the postpartum period to prevent Rh isoimmunization.
- Stem keywords: RhoGAM, Anti D, dose, after delivery
- Lead-in keywords: is?
Question ID
Q-WrI4EnM4AqvLWwRyVpkH
Reference Book
E6 Obstetrics Williams pp. 48-68, 1-9
Practise the full NIMHANS Nursing Officer - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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