A nurse is preparing to administer phytonadione 0.5 mg to a newborn. Which of the following routes should the nurse choose for administration of the medication?
A IM in right deltoid
B Subcutaneous in the right deltoid
C IM in left vastus lateralis
D Subcutaneous in the left vastus lateralis
The correct answer and Explanation is :
The correct answer is C: IM in left vastus lateralis.
Explanation:
Phytonadione, also known as vitamin K1, is administered to newborns to prevent vitamin K deficiency and associated bleeding disorders, particularly hemorrhagic disease of the newborn (HDN). Newborns have low levels of vitamin K due to limited placental transfer and the sterile environment of the gut at birth, which does not yet support the growth of vitamin K-producing bacteria.
Route of Administration:
- Intramuscular (IM) vs. Subcutaneous (SubQ):
- For newborns, the preferred route for administering phytonadione is intramuscular. The IM route allows for better absorption of the medication into the bloodstream compared to subcutaneous administration, particularly in neonates, where subcutaneous tissue can be less developed.
- Vastus Lateralis Muscle:
- The vastus lateralis muscle, located in the outer thigh, is the recommended site for IM injections in infants. This muscle is well-developed even in newborns, allowing for safe and effective administration of medications. The deltoid muscle (right deltoid in option A and subcutaneous in option B) is not typically recommended for newborns due to its smaller size and the risk of injury to nerves or blood vessels.
- Dosage Considerations:
- The standard dose of phytonadione for newborns is usually 0.5 to 1 mg administered IM within the first hours of life. The vastus lateralis muscle can accommodate this volume without risk of complications.
- Safety and Efficacy:
- Administering phytonadione via IM injection in the vastus lateralis ensures rapid absorption, effective prevention of vitamin K deficiency, and minimizes the risk of adverse effects, which may arise from improper injection techniques or sites.
In summary, the best choice for administering phytonadione to a newborn is an intramuscular injection in the left vastus lateralis, ensuring optimal absorption and effectiveness in preventing potential bleeding disorders.