A nurse is preparing to administer 1 mg Phytonadione to a neonate.

The medication is available in 1 mg/0.5 mL. How much should the nurse administer?

(Round to the nearest tenth. Use a leading zero when applicable. Do not use a trailing zero.)

Choice A rationale

Given the neonate’s symptoms and critically low blood glucose level (30 mg/dL), the most urgent action is to address the hypoglycemia. Therefore, the nurse shouldadminister a bolus of intravenous glucose (Option A). This immediate intervention is crucial to stabilize the neonate and prevent further complications associated with hypoglycemia.

Choice B rationale

While monitoring blood glucose levels is important, waiting 30 minutes to reassess without immediate intervention could allow the hypoglycemia to worsen, potentially leading to severe complications such as seizures or brain damage. Immediate treatment is necessary to stabilize the neonate..

Choice C rationale

Although feeding can help increase blood glucose levels, the neonate’s current symptoms (jitteriness, poor feeding, weak cry, and irritability) suggest that they may not be able to effectively feed. Additionally, the blood glucose level is critically low and requires more rapid correction than feeding alone can provide..

Choice D rationale

While maintaining an appropriate body temperature is important, the neonate’s temperature (36.1°C) is not critically low. The primary concern here is the hypoglycemia, which needs to be addressed immediately. Placing the neonate under a radiant warmer does not directly address the low blood glucose level..

Choice A rationale

Small for gestational age (SGA) refers to newborns whose birth weight is below the 10th percentile for their gestational age.

Choice B rationale

Appropriate for gestational age (AGA) refers to newborns whose birth weight is between the 10th and 90th percentiles for their gestational age. A newborn weighing 3350 g at 39 weeks gestation falls within this range.

Choice C rationale

Low birth weight is defined as a birth weight of less than 2500 g, which does not apply to this newborn.

Choice D rationale

Large for gestational age (LGA) refers to newborns whose birth weight is above the 90th percentile for their gestational age.