Family Nurse Practitioner Exam

What initial assessment should be done in a pregnant woman with a positive Coombs test?

1. Assess fetal heart rate

2. Conduct ultrasound for fetal abnormalities

3. Monitor for symptoms of hemolytic disease

4. Measure maternal blood type

The correct answer is: Monitor for symptoms of hemolytic disease

In the context of a pregnant woman with a positive Coombs test, monitoring for symptoms of hemolytic disease is crucial. A positive Coombs test indicates the presence of antibodies that can lead to hemolytic disease of the newborn (HDN), which may occur when there is an incompatibility between the mother's blood type and the fetus's blood type, often involving Rh incompatibility. By observing for symptoms of hemolytic disease, such as jaundice, anemia, or signs of fetal distress, healthcare providers can take timely action to manage the potential complications that may arise during the pregnancy and after delivery. This proactive monitoring is essential for the health of both the mother and the fetus, enabling early intervention if necessary. Assessing fetal heart rate is important, but it does not specifically address the risks associated with a positive Coombs test. Conducting an ultrasound for fetal abnormalities is a routine part of prenatal care but does not directly relate to the implications of a positive Coombs test. Measuring maternal blood type could provide useful information but is typically done prior to pregnancy or early in prenatal care, making it less relevant as an initial assessment following a positive test result. Thus, the focus on monitoring for symptoms of hemolytic disease is the most pertinent and immediate