ATI Active Learning Template (Medication) - Phytonadione (Vitamin K) Injection

ATI Active Learning Template (Medication) - Phytonadione (Vitamin K) Injection ATI Active Learning Template (Medication) - Phytonadione (Vitamin K) Injection Expected Pharmacological Action: Action: Required for hepatic synthesis of blood coagulation factors II (prothrombin), VII, IX, & X. Therapeutic Effects: Prevention of bleeding due to hypoprothrombinemia. Therapeutic Use: ● Prevention and treatment of hypoprothrombinemia, which may be associated with: Excessive doses of oral anticoagulants, Salicylates, Certain anti-infective agents, Nutritional deficiencies, Prolonged total parenteral nutrition. ● Prevention of hemorrhagic disease of the newborn. Complications: GI: gastric upset, unusual taste. Derm: flushing, rash, urticaria. Hemat: hemolytic anemia. Local: erythema, pain at the injection site, swelling. Misc: allergic reactions, hyperbilirubinemia (large doses in very premature infants), kernicterus. Medication Administration: ● IM route should generally be avoided because of the risk of hematoma formation; however, it is the preferred method for administration for prophylaxis of hemorrhagic disease of the newborn. Contraindications/Precautions: Contraindicated in: Hypersensitivity; Hypersensitivity or intolerance to benzyl alcohol (injection only). Use Cautiously in: Impaired liver function. Exercise Extreme Caution in: Severe life-threatening reactions have occurred following IV administration, use other routes unless risk is justified. Nursing Interventions: ● Monitor for frank and occult bleeding (guaiac stools, Hematest urine, and emesis). Monitor pulse and BP frequently; notify health care professional immediately if symptoms of internal bleeding or hypovolemic shock develop. Inform all personnel of patient’s bleeding tendency to prevent further trauma. Apply pressure to all venipuncture sites for at least 5 min; avoid unnecessary IM injections.● Pedi: Monitor for side effects and adverse reactions. Children may be especially sensitive to the effects and side effects of vitamin K. Neonates, especially premature neonates, may be more sensitive than older children. ● Lab Test Considerations: Monitor prothrombin time (PT) prior to and throughout vitamin K therapy to determine response to and need for further therapy. Interactions: Drug-Drug: ● Large doses will counteract the effect of warfarin. ● Large doses of salicylates or broad-spectrum anti-infectives may ↑ vitamin K requirements. ● Bile acid sequestrants, mineral oil, & sucralfate may ↓ vit. K absorption from GI tract. Client Education: ● Instruct patient to take phytonadione as directed. Take missed doses as soon as remembered unless almost time for next dose. Notify health care professional of missed doses. ● Cooking does not destroy substantial amounts of vitamin K. Patient should not drastically alter diet while taking vitamin K. ● Caution patient to avoid IM injections and activities leading to injury. Use a soft toothbrush, do not floss, and shave with an electric razor until coagulation defect is corrected. ● Advise patient to report any symptoms of unusual bleeding or bruising (bleeding gums; nosebleed; black, tarry stools; hematuria; excessive menstrual flow). ● Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with a health care professional before taking other medications and alcohol. ● Advise patient to inform health care professional of medication regimen prior to treatment or surgery. ● Advise patient to carry identification at all times describing disease process. ● Emphasize the importance of frequent lab tests to monitor coagulation factors. Evaluation of Medication Effectiveness: ● Prevention of spontaneous bleeding or cessation of bleeding in patients with hypoprothrombinemia secondary to impaired intestinal absorption or oral anticoagulant, salicylate, or anti-infective therapy. ● Prevention of hemorrhagic disease in the newborn.