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22/03/21
RBC 5.27
Hgb 117
Hct 0.52
MCV 99
Absolute nucleated RBC 0.1 (High could be due to increased erythropoiesis or acute stress mediated release from the marrow stores)
TSB: 168 (indicating patient is okay to stop phototherapy.)
DAT positive, indicating the result of jaundice is due to ABO incomparability.

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Received 3 days of phototherapy for treatment of pathological jaundice.

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Patient was referred to NICU by midwife that the mother had a great therapeutic relationship with.
Grandparents watch the oldest son while father visits in the hospital.

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HR- 154 upon auscultation. (Normal)
Capillary Refill less than 2 seconds. (Normal)
Diagnosed with ABO incompatibility pathological jaundice.

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Chest sounds clear.
RR- 32 Respirations per minute.
O2 Saturation 98% on room air.
(Normal Data)

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Vitamin D 400 IU PO Daily.
Supplement for bone health in infants who are breastfeeding.

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Mother present at the bedside.
Mother is engaged in the infant's care. Is aware of and meeting requirements for feeding and changes.
Providing skin to skin while breastfeeding and resting.
Father and mother supportive of each other. Father is home with the oldest son while mom is in hospital with the infant.
Patient is showing signs of recovery and improvement after phototherapy.
Mother has previous knowledge of hydrocele of testes from previous son's similar experience at birth.

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Patient was birthed Caesarian due to fetal deceleration for non reassuring heart rate and meconium stained amniotic fluid. Apgar score was 9 at 3 minutes and 10 at 5 minutes. Birth weight was 3.095kg putting this infant in the 50th percentile. Patient was referred by midwife to the NICU for phototherapy and observation on March 20th due to early onset neonatal jaundice with TSB of 195 at 25 hours.
Previous orders for TFI of 60mL/kg/day before ad lib feeding.

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Mother present at the bedside.
Father at home with son (brother) who is 4 years old.
Both maternal and paternal grandparents have offered to help with childcare for father's visits.
Mother reports wishing she was home and how her oldest son is excited to meet his brother.

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The infant was quiet alert and active alert during assessment.
Rooting, grasping, sucking, babinski, and moro reflexes present upon assessment.
Patient was moving normally within cot.
Pupils are equal and reactive to light.
At risk for bilirubin encephalopathy.

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Baby boy C.F.
DOB March 19th 2021
4 day old Neonate
Corrected GA 40 weeks 5 days.
Pathological Jaundice
Recently removed from phototherapy.
Current weight: 2.898 kg
Birth weight: 3.095 kg
Pews score 0

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Diaper was dry upon assessment. Last void recorded was at 0930 where patient had a wet diaper and a  small green stool.
Testes ultrasound at 1200 revealed moderate sized hydrocele on the right testis and small hydrocele to the left testis. Testes were slightly enlarged and swollen upon assessment.

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Birth Weight (March 19th 2021): 3.095 kg
Current Weight (March 23rd 2021): 2.898
Percent of Weight lost since birth: 6.37%
Feeds: Breastfeeding ad lib & enfamil 20 on demand.
Breast feeding well every 2-3 hours as reported by mom.
Upon assessment baby and mom had an effective latch.
Last diaper reported at 0930 was wet with a small green stool.
Pathological jaundice

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Patient was Jaundiced upon assessment with blanched skin and sclera appearing yellow.
Total serum Bilirubin 189 umol/L at 0830 which is below low risk levels for 96 hours post natal.
Fontanels are flat and soft upon palpation.
Temperature (Axilla): 36.9 degrees Celcius.

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Upon assessment the patient scored a 0 on the FLACC pain scale. The patient cried very little during assessment and was easily consolable by mom or pacifier. Patient remained in a normal position, legs were normal and relaxed and no significant facial expressions were observed.