Preparing for OB Clinicals: Administering Neonatal Medications

Eye Ointment Rationale: Administer antibacterial agent to newborn eyes to prevent ophthalmia neonatorum due to chlamydia or gonorrhea Drug of choice: Erythromycin 0.5% (5 mg/gm)

To Administer: Clean newborn’s eyelids with a clean, warm wash cloth but only if there is excessive vernix Use a different corner of the cloth for each eye to prevent cross-contamination Open eyelid and apply a ribbon of ointment into the conjunctival sac Start at the inner canthus and move towards the outer canthus/eye Repeat in opposite eye being sure not to cross contaminate Do not rinse eyelids. Leave on for at least 30 minutes

Considerations Some infants develop a mild inflammation after prophylactic treatment of the eyes. Usually resolves spontaneously The medication temporarily blurs the infant’s vision; parents may wish to delay treatment during the initial bonding period

Vitamin K Rationale: Adminster vitamin K (AquaMEPHYTON) intramuscularly to prevent bleeding problems until infant can produce its own clotting factors Dose: 1 mg per 0.5 mL

Injection Site: Vastus Lateralis Muscle

To Administer: Use the vastus lateralis muscle in the thigh Use the outer third (outer aspect) of the thigh Mid-way between the greater trochanter and the patella Stabilize the leg by holding the back of the thigh Clean skin with alcohol swab; circular motion Use 25 gauge 5/8” inch needle Enter at a 90 degree angle; (Z-track NOT used) Aspirate; if blood is drawn, remove and start over Inject the medication quickly; remove the needle and massage area with 2 X 2 gauze (not an alcohol swab! Gauze will stop the bleeding; alcohol swab will make it bleed more)

Stabilizing the Infant’s Leg

Hepatitis B Vaccine Rationale: To prevent the infant from acquiring the Hepatitis B virus Dose: 10 mcg/0.5 mL Pre-filled syringes; attach a 25 gauge 5/8” needle Refridgerated

To Administer: Use the same technique as used for Vitamin K administration however use the opposite leg This vaccine requires informed signed consent. Do not administer until you see the signed form! Document the injection in the newborn’s blue immunization record