The nurse is caring for a newborn who was circumcised using a Gomco clamp 12 hours ago and notes that there is a small amount of blood on his diaper where his penis rests against it.

The most appropriate nursing action would be to:

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

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