NCLEX · Antepartum, Newborn, and Postpartum Care

During the immediate newborn period, which of the following interventions is given to prevent hemorrhagic disease of the newborn?

  1. A Vitamin C injection
  2. B Vitamin K (phytonadione) injection, given within 6 hours of birth to prevent bleeding caused by low vitamin K levels in newborns
  3. C Erythromycin eye ointment
  4. D Hepatitis B vaccine

Why this is the answer

VITAMIN K (phytonadione) is administered to all newborns within 6 hours of birth to prevent VITAMIN K DEFICIENCY BLEEDING (VKDB), formerly called hemorrhagic disease of the newborn. WHY NEWBORNS ARE AT RISK: (1) Vitamin K does not cross the placenta well; (2) Newborns have limited intestinal bacteria (which produce vitamin K); (3) Breast milk contains low levels of vitamin K; (4) The newborn liver is immature in vitamin K-dependent clotting factor production. VKDB presents as: intracranial hemorrhage (brain bleed — can be fatal or cause permanent disability); GI bleeding; bleeding from umbilicus or circumcision site. DOSE: 0.5-1 mg IM (intramuscular) into the vastus lateralis (anterolateral thigh) within 6 hours of birth. PN ROLE: administer the injection per protocol; document administration; teach parents why it is given (some families decline due to misconceptions); explain it is one injection, not a series. ERYTHROMYCIN EYE OINTMENT is the prophylaxis for ophthalmia neonatorum (gonorrheal and chlamydial eye infection from birth canal exposure) — different purpose. HEPATITIS B VACCINE is given before hospital discharge (first dose in the series) — prevents hepatitis B infection. The combination of Vitamin K, erythromycin ointment, and hepatitis B vaccine in the immediate newborn period is standard of care in the US.
Source: NCLEX-PN Test Plan: Health Promotion — Newborn Care