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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