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 A

Explanation

The correct answer is choice A. Glycogen.Preterm newborns have limited stores of glycogen, which is a substance made from glucose that is stored in the liver and muscle cells to be used later for energy.When blood glucose levels are low, the hormone glucagon signals the cells to convert glycogen back into glucose and release it into the bloodstream.However, preterm newborns have a reduced ability to produce glucagon and to use gluconeogenesis, which is the process of making new glucose from other sources.Therefore, they are at risk of hypoglycemia, which is a condition where blood glucose levels are too low to support normal brain function.

Choice B is wrong because glucose is the sugar that travels through the blood to fuel the cells, not a substance that is stored for later use.

Choice C is wrong because insulin is a hormone that helps cells absorb glucose from the blood, not a substance that is stored for later use.

Choice D is wrong because glucagon is a hormone that triggers the release of glucose from the liver and muscle cells, not a substance that is stored for later use.

A. Pancreatitis B. Lactic acidosis C. Hypothyroidism D. Nephrotoxicity

Correct Answer is B

Explanation

The correct answer is choice B. Lactic acidosis.

Lamivudine (Epivir) is a nucleoside reverse transcriptase inhibitor (NRTI) used to treat chronic hepatitis B infection and HIV infection.

One of the rare but serious adverse effects of lamivudine is lactic acidosis, which is a condition where the blood becomes too acidic due to the accumulation of lactate.Lactic acidosis can cause symptoms such as nausea, vomiting, abdominal pain, muscle weakness, rapid breathing, and low blood pressure.

Choice A is wrong because pancreatitis is not a common side effect of lamivudine.

Pancreatitis is an inflammation of the pancreas that can cause severe abdominal pain, nausea, vomiting, and fever.Pancreatitis is more likely to occur with other NRTIs such as didanosine (Videx) or stavudine (Zerit).

Choice C is wrong because hypothyroidism is not a common side effect of lamivudine.

Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and energy levels of the body.

Hypothyroidism can cause symptoms such as fatigue, weight gain, cold intolerance, dry skin, hair loss, and depression.

Hypothyroidism is more likely to occur with other drugs that interfere with thyroid function such as amiodarone (Cordarone) or lithium

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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 caring for a preterm newborn who has hypoglycemia due to inadequate gluconeogenesis. The nurse should understand that this condition occurs because preterm newborns have limited stores of which of the following substances?

Correct Answer is A

Explanation

A nurse is caring for a client who has chronic hepatitis B infection and is taking lamivudine (Epivir). The nurse should monitor the client for which of the following adverse effects?

Correct Answer is B

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?