A nurse is caring for a newborn who has early-onset VKDB due to maternal use of anticoagulants during pregnancy.

Which of the following interventions should the nurse anticipate for this newborn?

Administer fresh frozen plasma

Administer packed red blood cells

Administer intravenous immunoglobulin

Administer recombinant erythropoietin

Answer and Explanation

The Correct Answer is A

The correct answer is choice A. Administer fresh frozen plasma. This is because fresh frozen plasma contains clotting factors that can help stop the bleeding caused by vitamin K deficiency. Vitamin K is needed for the synthesis of clotting factors in the liver, but newborns have low levels of vitamin K and may develop vitamin K deficiency bleeding (VKDB) if they do not receive prophylaxis at birth. VKDB can manifest as bleeding in various sites, such as the skin, mucous membranes, umbilicus, gastrointestinal tract, or central nervous system.

Choice B is wrong because packed red blood cells do not contain clotting factors and will not correct the underlying deficiency of vitamin K.

Choice C is wrong because intravenous immunoglobulin is used to treat immune-mediated thrombocytopenia, not vitamin K deficiency.

Choice D is wrong because recombinant erythropoietin is used to stimulate red blood cell production in anemia, not to treat bleeding disorders.

Early-onset VKDB occurs within 24 hours of birth and is associated with maternal use of drugs that interfere with vitamin K metabolism, such as anticoagulants, anticonvulsants, or antituberculosis drugs .

These drugs induce the enzymes that break down vitamin K in the fetal liver

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Correct Answer is B

Explanation

The correct answer is choice B. Check if there is any cross-sensitivity between erythromycin and penicillin.Erythromycin is a macrolide antibiotic that can be used to treat bacterial eye infections in newborns and adults.

Penicillin is a beta-lactam antibiotic that can cause allergic reactions in some people.

Cross-sensitivity means that a person who is allergic to one type of antibiotic may also be allergic to another type of antibiotic that has a similar structure or mechanism of action.Erythromycin and penicillin have different structures and mechanisms of action, but there is still a small chance of cross-sensitivity between them.

Therefore, the nurse should check if the newborn has any history of allergic reaction to penicillin before applying the erythromycin eye ointment.

Choice A is wrong because asking the mother if she has any allergies to antibiotics is not enough to determine if the newborn is at risk of an allergic reaction to erythromycin.

The newborn may have inherited or developed an allergy to penicillin or erythromycin that the mother does not have.

Choice C is wrong because applying a small amount of ointment on the skin to test for allergic reaction is not a reliable method to diagnose an allergy.Skin testing can cause false positive or false negative results, and it may also trigger a severe allergic reaction in some cases.

Choice D is wrong because administering an antihistamine to prevent anaphylaxis is not appropriate for a newborn who has not been exposed to the allergen yet.

An antihistamine is a medication that blocks the effects of histamine, a chemical that causes allergic symptoms.

Anaphylaxis is a life-threatening allergic reaction that involves multiple organ systems and requires immediate medical attention.An antihistamine cannot prevent anaphylaxis, and it may also cause side effects such as drowsiness, dry mouth, or low blood pressure in a newborn.

A. Factor II B. Factor V C. Factor VIII D. Factor XI

Correct Answer is A

Explanation

The correct answer is choice A.Factor II, also known as prothrombin, is one of the coagulation factors that are activated by vitamin K.Vitamin K is a cofactor for the carboxylation of specific glutamic acid groups in coagulation factors II, VII, IX, and X.

This process is essential for the activation of these factors in the coagulation cascade.

Choice B is wrong because factor V is not a vitamin K-dependent coagulation factor.

Factor V is activated by thrombin and acts as a cofactor for factor Xa in the conversion of prothrombin to thrombin.

Choice C is wrong because factor VIII is not a vitamin K-dependent coagulation factor.

Factor VIII is activated by thrombin and acts as a cofactor for factor IXa in the activation of factor X.

Choice D is wrong because factor XI is not a vitamin K-dependent coagulation factor.

Factor XI is activated by factor XIIa and activates factor IX in the intrinsic pathway of coagulation.

Normal ranges for coagulation factors are:

• Factor II: 70-120% of normal activity

• Factor V: 50-150% of normal activity

• Factor VIII: 50-150% of normal activity

• Factor IX: 50-150% of normal activity

• Factor X: 70-140% of normal activity

• Factor XI: 70-150% of normal activity

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A nurse is caring for a newborn who has early-onset VKDB due to maternal use of anticoagulants during pregnancy. Which of the following interventions should the nurse anticipate for this newborn?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is administering erythromycin eye ointment to a newborn who has a history of allergic reaction to penicillin. What should the nurse do before applying the ointment?

Correct Answer is B

Explanation

A nurse is reviewing laboratory results for a newborn who received vitamin K injection at birth. Which of the following coagulation factors should be activated by vitamin K?

Correct Answer is A

Explanation

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A nurse is caring for a newborn who has early-onset VKDB due to maternal use of anticoagulants during pregnancy.

Which of the following interventions should the nurse anticipate for this newborn?