e. Nursing intervention.
(1) Be careful and alert to infant's feedings. Due to poor muscle tone and
his protruding tongue, the infant may be a poor eater.
Observe for complications that may occur with Down's syndrome.
(a) Abdominal distention and vomiting.
(b) Irregularities in pulse of respiratory rate-cyanosis, tires easily with
Support the infant and carefully position him.
(4) Provide proper stimulation to meet the infant's needs-positive and
effective sensory stimulation.
Encourage parental participation in the infant's care.
11-8. ERYTHROBLASTOSIS FETALIS
a. This is considered a hemolytic disease of the fetus and newborn, which
stems from an incompatibility of fetal and maternal blood which results in maternal
antibody activity against fetal red blood cells (RBCs). This disease usually is a result
from Rh isoimmunization. During her first pregnancy, an Rh-negative female becomes
sensitized by exposure to Rh-positive fetal blood antigens inherited from the father. A
subsequent pregnancy with an Rh-positive fetus provokes increasing amounts of
maternal agglutinating antibodies to cross the placental barrier, attach to Rh-positive
cells in the fetus, and cause hemolysis and anemia. To compensate for this, the fetus
steps up the production of RBCs, and erythroblasts appear in the fetal circulation.
Extensive hemolysis results in the release of large amounts of unconjugated bilirubin,
which the liver is unable to modify and excrete, causing hyperbilirubinemia and
b. Signs and symptoms include:
(1) Jaundice - usually not present at birth but may appear as soon as 30
minutes later or within 24 hours after birth.