Newborn Meds

Vitamin K (AquaMEPHYTON, Mephyton, Konakion) dosage and route

.05-1mg given once IM within 1 hour of birth for prophylaxiz. May be delayed for breastfeeding in delivery room. May be repeated or higher doses used if the mother took anticonvulsants during pregnancy or it the infant shows bleeding tendencies.

5. What should you teach parents concerning how to tell the difference between chemical conjunctivitis related to the ointment and infectious conjunctivitis?

Any discharge from the eyes, especially if it is purulent, should alert the nurse to the possibility of infection. If the mother is infected the infant will need additional antibiotics bc routine prophylactic treatment may not completely prevent infection.

EMLA Cream ( (lidocaine 2.5% and prilocaine 2.5%)

Emla cream is often used for pain relief from circumcism procedures. It numbs the genital area prior to injection of lidocaine. Generally not used solely as a source of pain relief, but in combination with an injection. Side effects and nursing considerations are the same as its main ingredients, lidocaine.

Vitamin K (AquaMEPHYTON, Mephyton, Konakion) adverse reactions

Erythema, pain and edema at injection site; anaphylaxis, hemolysis, or hyperbilirubinemia, especially in a preterm infant or when a large dose is used.

Hepatitis B Vaccine (Engerix-B, Recombivax HB)

Indications: Prevention of hepatitis B in exposed and unexposed infants Dosage: Recombivax HB 5mcg, Engerix-B 10mcg AAP recommends giving all infants hep. B vaccination before they leave the hospital. Contraindications: hypersensitivity to yeast. Adverse reactions: pain or redness at site, fever Considerations: if a vial is used be sure to shake the solution well before preparing. Give within 12 hours of birth to infants with infected mothers. Bathe infants before shot is given. Obtain parental consent.

Hepatitis B Immune Globulin (HBIG)

Indications: prophylaxis for infants of hep B surface antigen positive mothers. Dosage: 0.5ml within 12 hours of birth if possible but no later than 1 week of age. IM Shot in anterolateral thigh. NOT IV Adverse reactions: pain and tenderness at site Considerations: do not shake or give IV. Bathe infants first to avoid contamination. Give vaccination and immune globulin at separate sites.

Vitamin K (AquaMEPHYTON, Mephyton, Konakion) nursing considerations

Protect the drug from light until just before admin, as it decomposes and loses potency after exposure to light. Observe all infants for signs of Vitamin K deficiency (bleeding from any site). Check that male infant has vitamin K before circumcision.

Erythromycin Ophthalmic Ointment (Ilotycin)-dosage

a "ribbon" of 0.5% erythromycin ointment, 1cm long, is applied to the lower conjunctival sac of each eye within 1 hour of birth

Erythromycin Ophthalmic Ointment (Ilotycin)-adverse effects

burning, itching, irritation may result in chemical conjunctivitis lasting 24-48 hours. Ointment may cause temporary blurred vision

Erythromycin Ophthalmic Ointment (Ilotycin) nursing considerations

cleanse the infant's eyes as needed before application. Hold the tube in a horizontal rather than a vertical position to prevent injury to the eye from sudden movement. Administer from the inner canthus to the outer canthus. do not touch the tip of the tube to any part of the eye, bc this may spread the infectious material from one eye to the other. Do not rinse. Ointment may be wiped form the outer eye after 1 minute. Observe for irritation. use a new tube for each infant to minimize spreading infection.

Erythromycin Ophthalmic Ointment (Ilotycin)-indications

inhibits protein synthesis in bacteria; Phrophylaxis against N. gonorrhoea and Chlamydia. Phrophylaxis against gonorrhoea is required by law even if mother is not known to be infected.

Vitamin K (AquaMEPHYTON, Mephyton, Konakion) Indications

prevention or treatment of vitamin K dependent bleeding. (hemorrhagic disease of the newborn)

Sucrose

• Indications- short term analgesia in infants during immunization administration • Dose/Route- oral 2ml and for older infants can do more • Side effects- bradycardia, brief apnea and O2 stat • Contraindications- hypersensitivity to sucrose and corn products • Nursing considerations- onto infants tongue, greater than 6 months put in upright position and get comfort from parent