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

Placing a baby on their back to sleep significantly reduces the risk of SIDS. This position helps keep the airway open and reduces the risk of suffocation.

Choice B rationale

There is no direct correlation between SIDS and the diphtheria, tetanus, and pertussis vaccines. Vaccines are safe and do not increase the risk of SIDS3.

Choice C rationale

SIDS rates have actually decreased over the last 10 years, largely due to public health campaigns promoting safe sleep practices.

Choice D rationale

Sleep apnea is not the main cause of SIDS. The exact cause of SIDS is unknown, but it is believed to be related to defects in the brain that control breathing and arousal from sleep.

Hyperbilirubinemia

• Symptoms: The neonate does show signs of jaundice (yellowish skin), which is a symptom of hyperbilirubinemia. However, the primary concern here is thelow blood glucose level (30 mg/dL), which is more immediately life-threatening and needs urgent attention.
• Diagnostic Results: The total serum bilirubin level is 5 mg/dL, which is elevated but not critically high. Hyperbilirubinemia might be a secondary concern, but the immediate symptoms and diagnostic results point more towards hypoglycemia.

Neonatal Abstinence Syndrome (NAS)

• Symptoms: NAS typically occurs in newborns exposed to addictive substances in utero, leading to withdrawal symptoms after birth. Common symptoms include irritability, high-pitched crying, tremors, and feeding difficulties.
• History: There is no mention of maternal substance use or withdrawal symptoms like frequent yawning or irritability. The jitteriness and poor feeding could overlap with NAS, but the history of gestational diabetes and the low blood glucose level make hypoglycemia a more likely diagnosis.

Summary

• Hypoglycemia: The neonate’s symptoms (jitteriness, lethargy, poor feeding) and the critically low blood glucose level (30 mg/dL) strongly indicate hypoglycemia. This condition is common in infants of diabetic mothers and large-for-gestational-age infants.