What is the dose of vitamin-K given to a newborn weighing > 1500 gm?

Appeared in: NHM MP Staff Nurse-2019

Explanation

Newborns have physiologically low levels of vitamin K, making them susceptible to Vitamin K Deficiency Bleeding (VKDB).
The standard prophylactic dose for newborns weighing 1500 grams or more is a single 1 mg injection.
The intramuscular (IM) route is the preferred method of administration because it ensures reliable absorption and provides a sustained release (depot effect), which is crucial for preventing all forms of VKDB, including the late-onset type.

Option A: A dose of 5 mg is excessively high for routine prophylaxis in a newborn and represents a therapeutic dose, not a preventive one.
Option B: While the 1 mg dose is correct for the infant's weight, the subcutaneous (SC) route provides less reliable and slower absorption compared to the intramuscular (IM) route, increasing the risk of prophylaxis failure.
Option D: A 2 mg dose is double the standard recommended prophylactic amount for a newborn of this weight and is not standard practice for routine prevention.

Clinical Relevance

Nursing practice connection: Knowing Prophylactic administration of Vitamin K in newborns helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Administering vitamin K is a critical nursing responsibility to prevent VKDB, a serious condition that can cause internal bleeding, including potentially fatal intracranial hemorrhage.
Nurses must accurately verify the infant's birth weight to ensure the correct dose is administered (1 mg for infants weighing 1500g or more, and 0.5 mg for those weighing less).
What if? If parents refuse the vitamin K injection, the nurse's primary responsibility is to provide clear education on the significant risks of VKDB. The refusal must be documented according to hospital policy, and the primary healthcare provider must be notified immediately.

How to Approach the Question

First, identify the key information in the question: the medication (vitamin K), the patient population (newborn), and the specific patient characteristic (weighing > 1500 gm).
Recognize this as a factual recall question that requires knowledge of standard neonatal medication protocols.
Recall the standard prophylactic dose and route for vitamin K based on a newborn's weight.
The standard protocol is 1 mg IM for infants weighing 1500 g or more.
Evaluate the options based on this standard. Eliminate options with an incorrect dose (5 mg, 2 mg) and the option with a less effective route (1 mg SC).
Select the option that matches the correct dose and the correct route of administration.

Concept Tested & Keywords

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

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