-CCS ~ Neonatal Jaundice- - pindi

[ArchivalUser]

4 day old baby born to a mother with diet-controlled gestational diabetes, brough to the office coz the baby looks yellow.

who wants to attempt this....
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just a little info on the topic....

50% of babies have jaundice.
it reflects accumulation of unconjugated bili in bld & tissues.
clinically observed at bld concentartion of 5 mg/dl or greater.
2 types...physiologic or non-physiologic.
physiologic jaundice never seen in 1st 24 hrs, and never esceeds 12.9-15 mg/dl.
Breast milk juandice seen at 1 week or 7days.
Breast feeding within 7 days...my understanding less than 7 days...

you can add more info about the neonatal jaundice on this thread...
this is a confusing topic...somewhat...just my humble opinion!

[ArchivalUser]

~ seems like i have to do this one too...hmmmm!

[ArchivalUser]

wait let me try

[ArchivalUser]

good...do a great job!

[ArchivalUser]

i will start with complete pe

then i will go for
iv access
cbc
retic
lfts
bilirubin
UA
BC

and if baby is vomiting or dehydrated
will add

.9%NS


and admit to ward

[ArchivalUser]

all depends on reports...now whether ist conjugated or unconjugated!!!

[ArchivalUser]

i forgot
type and cross match
Rh factor

[ArchivalUser]

thansk for trying stefan..

well exchange tranfusion is in case baby is seizing...kernicterus....my understanding!
and this one just appeared in the office..looking YELLLOW...
so most likely it will be physiologic on day # 4......

[ArchivalUser]

i find in these 2 cases NEONATAL SEPSIS and NEONATAL JAUNDICE ...very difficult...maybe coz i am not a pediatrician and never want to be...but God Bless them...we need them!

let me try now...

~ PE: complets..except breast and genitalia and rectal!

~ Orders:
cbc
bmp
lfts
peripheral smear
retic count
Coomb's test
Bili...dircet
Bili...indirect
Baby's ~Rh type
Mom's ~Rh type

no ABO incompatability
no Rh incompatability
No leukocytosis
Bili unconjugated 11 mg/dl

now i am not sure if the pt needs to be admitted for this bili level...

~ treatment
hydration...oral/breast feeding
observation
f/u bili level ckecks
IVF choice would be D51/2NS....

please make corrections...

[ArchivalUser]

UA to be done as well....
mom and baby's blood type as well..