Newborn Medications: RPN and LPN Administration and Monitoring

The RPN/LPN working in the newborn nursery or postpartum unit frequently administers the three routine newborn medications. Safe administration and clear family teaching are core competencies. Erythromycin Eye Ointment: - Clean the newborn's eyes with a clean cloth before instillation - Instill a thin ribbon of ointment into the lower conjunctival sac of each eye - Do NOT flush the eyes after — this washes out the medication - May be delayed up to 1 hour after birth to support parent-infant bonding - Teach parents: the ointment may cause mild eye swelling; this resolves within 24–48 hours Phytonadione (Vitamin K₁) IM: - Inject into the lateral middle third of the vastus lateralis (anterolateral thigh) - Use the correct needle length for the neonate's muscle mass - Protect the vial from light at all times - After injection: monitor for bruising at the injection site and for umbilical cord bleeding - Reassure parents about the reason: newborns lack the gut bacteria to make vitamin K and need this single injection to prevent serious bleeding - Explain that oral vitamin K is...