A 6-Hour-Old Boy Is Being Evaluated in the Nursery

question 179

Multiple Choice

A 6-hour-old boy is being evaluated in the nursery.  He was born at 39 weeks gestation via spontaneous vaginal delivery to a 33-year-old primigravida.  The pregnancy was complicated by intravenous drug use, and the mother was incarcerated for 2 months during the second trimester.  First trimester serologies, including RPR, HIV antibodies, and hepatitis B surface antigen (HBsAg) , were negative.  Due to the mother's risk profile, follow-up testing was obtained during the third trimester and revealed the following: Liver function testing was normal.  Hepatitis C and repeat HIV testing were negative.  The remainder of the pregnancy was uncomplicated.  The infant weighs 3.7 kg (8 lb 3 oz) .  Physical examination of the infant is normal.  There is no jaundice or hepatomegaly.  Which of the following is the most appropriate next step in management of this infant?

• A)Administer hepatitis B immune globulin
• B)Administer hepatitis B immune globulin and vaccine
• C)Administer hepatitis B vaccine
• D)Obtain hepatitis B antibody panel
• E)Obtain liver function testing
• F)Restrict breastfeeding

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