A nurse is preparing to administer 1 mg vitamin K to a newborn. 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 reason:

Purple striations: Purple striations, or stretch marks, are more commonly associated with Cushing’s syndrome, which involves excess cortisol production. Addison’s disease, on the other hand, is characterized by insufficient cortisol and aldosterone production.

Choice B reason:

Hirsutism: Hirsutism refers to excessive hair growth in women in areas where hair is normally minimal or absent. It is not typically associated with Addison’s disease. Hirsutism is more commonly linked to conditions involving excess androgens, such as polycystic ovary syndrome (PCOS).

Choice C reason:

Hyperpigmentation: Hyperpigmentation, or darkening of the skin, is a hallmark symptom of Addison’s disease. This occurs due to increased production of melanocyte-stimulating hormone (MSH) as a byproduct of elevated adrenocorticotropic hormone (ACTH) levels. The skin changes are often most noticeable in areas exposed to friction, such as the elbows, knees, and knuckles.

Choice D reason:

Intention tremors: Intention tremors, which occur during purposeful movement, are not typically associated with Addison’s disease. These tremors are more commonly seen in neurological conditions such as multiple sclerosis or cerebellar disorders.

Choice A reason: Generalized Urticaria

Generalized urticaria, or widespread hives, is a common sign of an allergic transfusion reaction. This reaction occurs when the recipient’s immune system reacts to proteins in the donor blood. Symptoms can range from mild, such as itching and hives, to severe, including anaphylaxis. Immediate intervention typically involves stopping the transfusion and administering antihistamines.

Choice B reason: Distended Jugular Veins

Distended jugular veins are not indicative of an allergic transfusion reaction. This finding is more commonly associated with conditions such as congestive heart failure or fluid overload. In the context of a blood transfusion, it could suggest circulatory overload rather than an allergic reaction.

Choice C reason: Blood Pressure 184/92 mm Hg

An elevated blood pressure reading, such as 184/92 mm Hg, is not specific to an allergic transfusion reaction. While blood pressure changes can occur during a transfusion, they are not a hallmark of an allergic response. This finding could be related to other factors, such as anxiety or pre-existing hypertension.

Choice D reason: Bilateral Flank Pain

Bilateral flank pain is not a typical symptom of an allergic transfusion reaction. This symptom is more commonly associated with hemolytic transfusion reactions, where the recipient’s immune system attacks the donor red blood cells, leading to hemolysis and subsequent kidney pain.