12.11 Phytonadione (Vitamin K)

Overview

  1. IM injection given shortly after birth
  2. Also known as Vitamin K

Nursing Points

General

  1. Why it’s routinely given: Newborns are born without coagulation factors  
  2. This is given to prevent any hemorrhagic disorders that may result, as newborns are deficient in vitamin K at birth.

Assessment

  1. Monitor for bleeding

Therapeutic Management

  1. Given IM
    1. Administer IM injection in thigh (vastus lateralis)
      1. Hold them tight because they’ll move!
  2. Given 1 hr after birth
    1. Remember skin to skin time with mother is priority, this can be given after the Golden Hour

Nursing Concepts

  1. Pharmacology
  2. Clotting

Patient Education

  1. Purpose
  2. Vitamin not vaccine
  3. Risks if they do not receive it

Reference Links

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Video Transcript

In this lesson I will help you understand that use of phytonadione in the newborn and your role in this care.

Phytonadione is known as vitamin K. It is given at 1 hour of life for the newborn. Newborns are not born with all the coagulation factors that they need and don’t start to produce them until after a week so vitamin K is given to protect from big bleeds. Vitamin K will help the liver to make the clotting factors until they produce enough on their own. Newborns are at big risk for hemorrhagic disease of the newborn. This is where they just bleed because they don’t have clotting factors so they bleed from the umbilical stump, mucus membranes or head bleeds. Years and years ago babies would just die because of bleeds and then they realized that all babies are born vitamin K deficient. So now we can save these babies by giving vitamin K. It is so frustrating to me when we have something so simple to fix something so awful and people refuse it for their newborn. So there are some moms that have done what they believe to be good research and think their newborn will get it in breast milk or formula but they don’t get enough. There are some moms that just do not want their baby to get a shot. These moms will typically ask for oral vitamin K but it is not absorbed as well so it doesn’t give them enough. So this is where it gets so complicated. The doctors and nurses want to shake these parents and tell them “your baby could die” and I won’t lie some doctors do just straight up say this but the parents at times still refuse. So be the nurse that advocates for vitamin K and don’t be that parent that refuses it because it is lifesaving!

Assessment will be to monitor for any bleeding. Management will be to given as an IM injection in thigh. You will need to hold them tight because they’ll move! It is given 1 hr after birth. Remember skin to skin time with mother is priority, this can be given after that Golden Hour

Education should be given on the purpose of the medication. So why are we giving a shot to their newborn? There are some patients that want to refuse this but it is a very important medication so if they want to refuse it then we want to explain that it is a vitamin and not a vaccine. Also include the risks if their baby does not receive it. And hopefully this education will allow them to see the benefit for their baby.

Pharmacology and clotting are the concepts because this medication helps with clotting factors.

Ok so the important stuff. Phytonadione is vitamin K and it is a 1 mg IM injection given at one hour of life to prevent hemorrhagic disease of the newborn.

Make sure you check out the resources attached to this lesson and review key points. Now, go out and be your best selves today. And, as always, happy nursing.

Read more

  • Question 1 of 5

The nurse is preparing to administer phytonadione to a newborn. By what route is this administered?

  • Question 2 of 5

Vitamin K is being administered to a newborn at one hour of life. Which injection site should be used?

  • Question 3 of 5

A client refuses the phytonadione medication for her newborn. Which of the following could occur because of this?

  • Question 4 of 5

The labor and delivery nurse is caring for a newborn. The nurse knows that phytonadione should be given when?

  • Question 5 of 5

Parents of a newborn baby are asking the nurse about the role of phytonadione. The best response from the nurse is which of the following?

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