History Baby Full Question & Answer Guide (With Explanation)
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Original Question
HISTORY Baby PG, a full-term female baby was delivered via NSD on 4-20-22 (12:30 PM) with birth weight 3.2 kg at 39th week of gestational age. Baby PG cried soon after birth, No congenital anomalies seen at the time of birth. Vaccination is given. Injection Vit. K 0.1 ml given. Breastfeeding started after 2 hours and the baby was fed every 2-3 hours c/o mother. At 9:00 am on 4-21-22,the patient’s mother and the nurse noticed that Baby G started to develop mild yellow discoloration in whole body. The mother’s observation was then referred to Dr. Reyes where serum total bilirubin was ordered and done revealing 13 .2 mg/dl thus phototherapy was ordered. Endorsement: VS q2 especially temperature, For phototherapy with precaution (Started 12pm), Encourage to increase fluid intake/breastfeeding, hook to IV D5 0.3 NaCl at 100ml/kg/day or 13 cc/hr ((hooked at 12:10 pm) at Right basilic vein. For repeat serum total bilirubin after 12 hours. Investigation (Labs): Hemoglobin% – 17.8gm% Blood group- A positive, CRP- Negative Bilirubin level (Before treatment) – Total – 13.2 mg/dl Direct bilirubin- 2.6 mg/dl Indirect bilirubin- 10.6 mg/dl. Anthropometry – 1. Head circumference 33 cm. 2. Chest circumference 31 cm 3. Mid arm circumference (both) 9.5 cm 4. Mid thigh circumference (both) 12 cm 5. Height 49.5 cm 6. Weight 3.2 kg VITAL SIGNS: APRIL 21, 2022 8AM 10AM 12PM TEMPERATURE 36.5 37.3 37 RESPIRATORY RATE 34 30 38 HEART RATE 137 140 143 STOOL – – – URINE 1DC (1.5 oz) 1DC (1 oz) Meconium at 1:00 pm Phototherapy started 12:00 pM Medication: Iron supplement (Ferlin drops) 0.3cc OD History- Full term female baby (39th week), LSCS delivery, cried immediately after birth, birth weight- 3.2 kg. Antenatal History: Age of mother at the time of conception was 22 years and the father was 25 years. Mother took regular antenatal checkups and took medicine on time, No history of any kind of infections, pregnancy induced hypertension, diabetes, or seizures was reported. Blood type: O+ (mother) Postnatal Family History: All family member said to be normal. Immunization History: BCG, OPV, HepB0 Dietetic History: Exclusive breastfeeding started after 2 hour of birth. Personal History: Appetite -Good Meconium- Passed Micturition -passed Sleep -Normal General Examination Lung- expanded, Activity- Alert Color- pink Apgar score- 1 st min- 8/10 5 th min. 10/10 Ballard score- 40 (40th week of gestational age) No any congenital anomalies. No any abnormal secretion from umbilical cord CBC: Hemoglobin- 17.8 RBC- 5 Hematocrit- 54% WBC-9,000 mm3 Neutrophil-normal Lymphocytes-normal Blood type- B+ QUESTIONS 1. List the Cephalocaudal (Head to Toe) Assessment and its findings for Normal Newborn. 2. What most likely causes the jaundice in the above case scenario?
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