Generic Name:Vitamin K(Pytonadione)
Classification:fat-soluble vitamins,Antifibrinolytic Agents
Phytonadione is used in prophylaxis and treatment of hemorrhagic disease of the newborn. It promotes liver formation of the clotting factors II, VII, IX and X. At birth, the newborn does not have bacteria in the colon that necessary for synthesizing fat-soluble vitamin K.Therefore,the newborn may have deceased levels of prothrombin during the first 5 to 8 days of life reflected by a prolongation of prothrombin time.
Intramuscular injection is given in the vastus lateralis thigh muscle.A one time only prophylactic dose of 0.5 to 1 mg is given intramuscularly in the birthing area within 1 hour of birth.
If mother receive anticoagulant during pregnancy, an additional dose may be ordered by the physician and is given 6-8 hours after the first injection,IM/subcutaneous concentration: 1 mg/0.5 ml(neonatal strength)can use 10 mg/ml concentration to minimize volume injected.
Neonatal Side Effects
Pain and edema may occur at injection site. Allergic reaction such as rash and urticaria,may also occur.
- Document the giving of the medication to newborn to prevent an accidental doubling of the dose.
- Observe for bleeding (usually occurs on second or third day). Bleeding may be seen as generalized ecchymoses or bleeding from umbilical cord, circumcision site, nose or gastrointestinal tract.
- Observe for jaundice and kernicterus,especially in preterm infants.
- Observe for signs of local inflammation.
- Apply pressure to the injection site to prevent further bleeding
- Protect drug from light.
- Give vitamin K before circumcision procedure
Credit:Contemporary Maternal Newborn Nursing Care sixth edition