Vitamin K Deficiency Bleeding

Overview and Considerations

Caroline W. Burke, MSN, RN, CPNP


J Pediatr Health Care. 2013;27(3):215-221. 

In This Article

Physical Examination

Upon physical examination the infant was irritable and crying and was unable to be consoled by his mother. He weighed 5.2 kg (75th percentile) and had a head circumference of 38.0 cm (50th percentile) and a length of 55 cm (50th percentile). His vital signs were as follows: temperature, 38.1°C; heart rate, 112 beats per minute; respiratory rate, 49 breaths per minute; blood pressure, 100/38 mm Hg; and oxygen saturation, 99% on room air. His head was atraumatic and normocephalic, with anterior and posterior fontanels open and notably full. His pupils were equal, round, and briskly reactive to direct light, 2 to 3 mm bilaterally. The red reflex was present bilaterally, and no eye deviation was noted. The infant's nares were patent bilaterally, with no drainage, swelling, or lesions. His lungs were clear to auscultation bilaterally, and he had no retractions or nasal flaring. The patient's heart sounds were regular with no murmur, and his brachial and femoral pulses were 2+ bilaterally. His abdomen was soft, rounded, and nondistended, with no palpable masses or hepatosplenomegaly. The penis was circumcised and well healed with no discharge, swelling, or bleeding. The infant's testes were descended bilaterally, and he voided to an open diaper during the physical examination.

The infant had a 2 by 3 cm red, flat lesion at the base of the skull that the mother reported has been present since birth; however, no rash, petechiae, or purpura was noted. His skin was moist with good skin turgor. He had symmetric, spontaneous movement of all extremities. His tone was normal, and no arching, tremor, clonus, or seizures were appreciated. His palmar, plantar, moro, rooting, and stepping reflexes were intact. Although he was noted to have a weak suck, his cough and gag reflexes were intact.