ANSWER TO EACH CLASSMATE
1 REFERENCE PER CLASSMATE
3-4 SENTENCE RESPONSE PER CLASSMATE IS FINE
BASE ON THE CASE STUDY
Newborn Case study
This is a 3-day old female, birth weight of 7lbs 3 oz born at 39 weeks’ gestation to a 28-year-old gravida 3 para 2002 mother.
The older children are a boy that is 6 and a girl that is 3. The parents have been together for 2 years in a stable caring relationship. The father is in the military and currently deployed.
Mother reports baby is breastfeeding every 2 hours and is healthy. Mother states that the baby appears more “yellow” than she remembers either of her other children were after birth and is concerned about jaundice.
Mother also reports that her 3-year-old is very clingy and non-cooperative. As you begin to examine the baby the mother asks what the bump on the left side of the baby’s head is from (cephalohematoma). She states she did not notice anything like this on her 2 other children after birth.
Physical exam:
The vital signs are temp axillary 37.2 Celsius, pulse 138, resp rate 46.
Biometrics include weight at 3.2kg (45%), length 51cm (75%) and head circumference 34cm (75%) is this normal?
Yellow hue to nipple line, anterior fontanel is flat and slightly sunken. There is mild left sided cephalohematoma, soft with noted bruising is present. Sclera is mildly icteric with a very small dot of red close to the iris (scleral hemorrhage). Mild palpable edema at both breast under nipple area without any redness noted, neck is soft and supple without mass, abdomen is soft and hollow without palpable mass or HSM. Muscle tone is normal flexed position and reflexes are intact including moro, strong suck/swallow, step, grasp. diaper area and genitals normal for newborn female.
CLASSMATE 1
What baseline history about the birth and neonatal course might be important for you to make an adequate assessment, diagnosis of any problems and plan of continued care for this infant and her family?
Baseline information that I would like to have regarding the birth of the infant would be: Was it a traumatic birth, meaning were forceps used or was suction used in the delivery of the infant? Did the mother have adequate pre-natal care? How are the other children handling the new baby? Are they careful around the baby or does the mother fear that the 3-year-old that is being clingy will harm the baby out of jealousy?
CLASSMATE 2
What are the possible short term or long term sequela of cephalohematoma for this infant?
Cephalohematoma is a minor condition that occurs during childbirth. It is a slow subperiosteal bleed which is a secondary condition that developed from the fetal head being compressed against the maternal pelvis during birth. Monitoring the infant closely in the first week is of the utmost importance.
CLASSMATE 3
What possible diagnosis could you identify?
Jaundice.
CLASSMATE 4
What additional test might have been done at the hospital on the newborn that you need to review and follow-up?
Mother and newborn blood type and RH type.
Congenital test
Drug test
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