Through which of the following routes does vitamin K need to be administered soon after birth?

Tripura CHO - 2021

Child Health Nursing (Pediatrics)

Easy

Appeared in: Tripura CHO - 2021

Explanation

The intramuscular (IM) route is the standard of care for vitamin K administration in newborns.
IM injection provides a depot effect, ensuring slow, sustained release and reliable absorption, which is crucial for preventing all forms of Vitamin K Deficiency Bleeding (VKDB).
The recommended site is the vastus lateralis muscle in the thigh, as it is well-developed in newborns and can safely accommodate the injection volume.
A single IM dose is almost universally effective, making it superior to other routes like oral administration, which requires multiple doses and has variable absorption.

Option A: Oral vitamin K has unreliable and variable absorption. It requires a multi-dose regimen and has been shown to be less effective than a single IM dose, particularly in preventing late-onset VKDB.
Option B: The intradermal route is used for delivering very small volumes into the dermal layer of the skin, primarily for sensitivity tests like the tuberculin (PPD) test or allergy testing. It is not suitable for vitamin K administration due to the volume and required systemic absorption.
Option C: Subcutaneous injection provides less reliable and potentially more erratic absorption compared to the intramuscular route. For a critical prophylactic medication like vitamin K, consistent absorption is essential.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Vitamin K Prophylaxis in Newborns as background academic context rather than a clinical decision trigger.
Administering vitamin K is a critical nursing responsibility to prevent VKDB, a serious and potentially fatal bleeding disorder in newborns.
Nurses must educate parents on the importance of vitamin K prophylaxis, addressing any concerns or misinformation, and obtain informed consent as per hospital policy.
Accurate documentation of the administration, including the dose, route, site, date, and time, is a crucial legal and clinical responsibility.

How to Approach the Question

First, identify the core of the question: it's asking for the standard, recommended route for a specific medication (Vitamin K) in a specific population (newborns).
Recall routine newborn care procedures. Vitamin K administration is a universal step.
Evaluate each option based on principles of medication administration. Consider the purpose of the medication (prophylaxis against bleeding) and the need for reliability.
The intramuscular route is known for reliable, systemic absorption, making it ideal for prophylactic medications where consistent blood levels are important.
Eliminate other options: Oral is less reliable, intradermal is for testing, and subcutaneous has more erratic absorption than IM. This confirms Intramuscular is the best and correct choice.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 pp. 527-529, 1138-1140