A mother refused to allow her son to receive the phytonadione (Mephyton) injection at birth as was stated on her birth plan.Which of the following signs or symptoms might the nurse observe in the baby as a result?
Vital signs are unstable.
Glucose levels are low.
Skin has acrocyanosis.
Circumcision site oozes blood.
The Correct Answer is D
Choice A rationale
Unstable vital signs in a newborn could be attributed to various causes such as infection, respiratory issues, or cardiovascular problems. It is not directly linked to the absence of phytonadione injection.
Choice B rationale
Low glucose levels in a newborn can result from conditions like prematurity, maternal diabetes, or feeding issues and are not a direct consequence of the absence of a phytonadione injection.
Choice C rationale
Acrocyanosis, a bluish discoloration of the hands and feet, is a common and benign finding in newborns due to immature blood circulation and is not related to the absence of phytonadione.
Choice D rationale
Phytonadione (vitamin K) is essential for blood clotting. Absence of this injection can lead to bleeding issues, such as oozing at circumcision sites, due to vitamin K deficiency bleeding (VKDB).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.8"]
Explanation
Step 1 is 0.2 mg × 4 doses = 0.8 mg
The total amount the patient will receive in a 24-hour period is 0.8 mg.
Correct Answer is C
Explanation
Choice A rationale
Drying and covering the infant helps prevent heat loss and maintain body temperature, which is essential for newborns immediately after birth.
Choice B rationale
Stimulating the infant to cry helps clear the airways but is usually done after ensuring the respiratory tract is clear.
Choice C rationale
Clearing the respiratory tract is the priority immediately after birth to ensure the newborn can breathe properly and reduce the risk of aspiration.
Choice D rationale
Assessing the umbilical cord is important but not the first priority. Ensuring the airway is clear takes precedence to establish effective breathing. .
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