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Discussion 5 – Newborn Evaluations

Discussion 5 – Newborn Evaluations

Sample Answer 

Discussion 5 – Newborn Evaluations

Newborn Evaluation

The vital signs indicate that the baby is normal, with slightly high temperatures. Rectal temperatures of 99.7F are considered normal, while a similar armpit temperature is a sign of a fever. In this case, the VS is not specific. Having been born at 38 weeks of gestation, the pregnancy is considered to have gone a full term. Additionally, social history indicates that the parents are not exposing the infant to any harm before and after delivery. I will want to know if the parents have noticed any other signs, such as irritability. I would also wish to understand the genetic compositions of the family, including family history concerning MSUD.

The parents report that there are no unexplained fevers except for the sweet-smelling wet diapers and increased sleep. The signs and symptoms presented during the visit suggest a possible maple syrup urine disease (MSUD), which is a metabolic disorder that affects the branched-chain amino acids and manifests in urine, especially before diagnosis and during acute illness (Biswas, et al. 2018). The disease is named MSUD due to the sweet-smelling urine that resembles maple syrup. Classic MSUD usually displays symptoms, including poor bottle or breastfeeding, irritability, and lethargy within two to three days (Harris-Haman, Brown, Massey, and Ramamoorthy, 2017).

Based on my findings, I would propose a diagnosis, including tandem mass spectrometry, which measures the blood concentration of leucine. I would alternatively propose the urine of the newborn be analyzed to determine the levels of branched-chain alpha-ketoacids and alpha-hydroxy acids. The state of Alabama provides several programs and laws for families that seek to provide quality care for their members. For instance, the Board of Health provides funding for metabolic formula upon enrollment through metabolic clinics. The parents could also benefit from the funding if they are not eligible for WIC. The Maternal Child Health Bureau also supports children with similar conditions.

References:

Biswas, L., et al. (2018). When Newborn Screens Fail, Maple Syrup Urine Disease in a Toddler.

Harris-Haman, P., Brown, L., Massey, S., & Ramamoorthy, S. (2017). Implications of maple syrup urine disease in newborns. Nursing for women’s health21(3), 196-206.

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Question 


Discussion 5 – Newborn Evaluations

Discussion Prompt:

  • Please evaluate the subjective and objective information provided to you in the file below. 
  • First to identify all pertinent positive and negative information.
  • Is there any other information you would want to obtain?
  • Create a differential diagnosis list with at least 3 possibly actual diagnosis based on your findings. 
  • Next, create a plan utilizing clinical practice guidelines for the priority diagnosis. 
  • What state (Alabama) or federal resources are available to these parents?
  • What health promotion recommendations may you want to consider?
  • Be sure to include APA in-text 2 scholarly citations and provide full reference citation at the end of the discussion.

    Discussion 5 – Newborn Evaluations

    Discussion 5 – Newborn Evaluations

***File Below:

 NU632 Unit 5 Discussion Case

C.C. 3-dayold checkup

HPI: Mother and Father present to clinic in Central Pennsylvania with their 3-dayold son.  3 day old. M was born at home at 38 weeks’gestation.  Since his birth, mother has noticed poor feeding habits, very few sweet-smelling wet diapers and sleeping more.  This was their 4thhome delivery, 3 living children without any develop mental or medical concerns.  Have never experienced this behavior with their other children who are now 5, 4, 1.

PMH: Born at 38 weeks’ gestation vaginally at home. There were no complications at birth. There were no complications throughout the pregnancy. The infant’s mother denies tobacco use, drug use, or alcohol use during pregnancy. The infant is breastfed. The siblings are not vaccinated. Allergies: No known drug allergies Medications: None Social History: The infant lives with his mother, father, siblings and maternal grandparents. Live on a farm in Lancaster County.  Mennonite. Mother stays at home with children and father works on the family farm/wood mill. The infant is not exposed to tobacco smoke. Family History: Mother and father deny any significant medical history. Siblings have no significant medical history and are not up to date on immunizations.

Review of Systems

General: Mother denies unexplained fevers. Concerned about increase sleep, weak suck and poor eating habits. Skin: The infant’s mother denies any rash or lesions. Head: Mother denies any trauma/forceps used in birth. ENT: Mother denies any concerns with the infant’s ears, nose, or throat. Neck: Mother denies any concerns with neck.CV: The infant’s mother denies any cyanotic spells or a discoloration of the skin. Lungs: The infant’s mother denies any cough, congestion, wheezing, or difficulty breathing.GI: Mother reports 1 bowel movements per day, dark in color.   Denies meconium during birth. GU: Negative for diaper rash. Mother has reported decrease number of wet diapers and has noticed a sweet odor when changing cloth diaper.

Objective VS: Temperature: 99.7F, HR: 161, RR: 52 Ht: 21in, Wt.: 6lbs, 4.6 oz, HC: 46.1cm

General: Appears lethargic, sunken eyes, pale skin. Laying on table in “fencing” pose. Skin: No evidence of rash or lesions. Head: Normocephalic. Eyes: The lids and conjunctiva are normal. Pupils are irises are normal fundoscopic exam reveals red reflex present bilaterally. ENT: Normal external ears and nose. Normal external auditory canals and tympanic membranes. Tip of otoscope sweet smell once removed from ear. Oropharynx: normal mucosa, palate, and posterior pharynx.

Neck: Supple, no adenopathy.CV: Tachycardic and rhythm. A faint murmur noted. Femoral pulse 2+ bilaterally. Lungs: Increase respirations with nasal flaring, lungs clear bilaterally. Abd: Hypoactive bowel sounds. No masses or tenderness or organomegaly observed.GU: Penis: normal uncircumcised male. Testes descended with no inguinal hernia noted. MSK: Poor tone and muscle strength. Negative for “hip click”.

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