Question

Ms. B had her second baby two days ago and is planning to leave the hospital soon. The Family Practice MD has discharged both the mom and baby after Ms. B has her RhoGAM, rubella immunization and if her lab work comes back normal. Her CBC is: Hgb 12.2 (12-16); HCT 42 (37-47); WBCs 21,000 (5,000-15,000). She has Tylenol # 3 ordered to take home. You go in and ask her if she would like you to call in her prescriptions to a pharmacy. She really needs the pain meds but is hesitant to take them because she is breastfeeding. She also doesn’t want to get the rubella vaccination because she is breastfeeding. She asks why she needs RhoGAM.

1. What’s up with the lab test results?
2. Why the RhoGAM and rubella?
3. What would you do about her refusing to get the rubella vaccination?
4. How about pain medication and breast-feeding?

Answer 1

Lab results.

All the test results except WBC are normal.

Normal White Blood Cells is 5000-15000.During labour WBC count increases marked leukocytosis.And it returns to normal after 1 week.

2)RhoGAM and rubella.

According to CDC rubella vaccine does not interact with doses of Rho immunoglobulin.But it is necessary to check to know if the person is protected from rubella infection.

3)Rubella is a viral infection which spread from direct contact through saliva or mucous.

Rubella is a dangerous infection which can affect the infant when it is in womb if mother is suffering from it.And rubella can be transmitted to infant from mother through breast milk.So it is necessary to receive vaccination for rubella because it is dangerous for both mother and the infant.Because Ms B is breast feeding her baby.

4)Tylenol is given to babies to give relief for pain and fever so it is also safe for breast feeding mother's to use.So there is no reason for refusing pain medication.