Solved

A 60-Hour-Old Boy Is Evaluated in the Newborn Nursery Prior

question 430

Multiple Choice

A 60-hour-old boy is evaluated in the newborn nursery prior to anticipated discharge. He was born via vaginal delivery with vacuum assistance at 38 weeks gestation. Prenatal maternal group B streptococcus screen was positive, for which the mother received antibiotics during labor and delivery. Other prenatal laboratory studies were normal. Maternal blood type is A+. On day of life 1, the patient was noted to have a well-demarcated scalp swelling that has remained stable in size. He is breastfed exclusively and has had 3 wet diapers in the last 24 hours. Physical examination shows an alert and active boy with appropriate tone and a strong cry. He has icteric sclerae, jaundice from the face to the lower abdomen, and a 2 x 3 cm scalp swelling over the right parietal area. The remainder of the examination is unremarkable. Laboratory results are as follows: Phototherapy is initiated, and repeat total bilirubin 6 hours later is 17.1 mg/dL. The father says, "We really want to take our baby home. Can we supplement with formula and keep him by the window to get sunlight?" Which of the following is the best next step in management of this patient?

Definitions:

Duty

An obligation required by one's position, societal norms, or law, to conduct oneself in a certain manner.

Breach

The violation of a law, duty, or other form of agreement, often leading to legal action or sanctions.

Comparative Negligence

A legal doctrine that allocates damages based on the degree of fault or negligence of each party involved in an incident, reducing compensation accordingly.

Assumption of the Risk

A defense in tort law that a person knowingly exposed themselves to a dangerous situation and is therefore responsible for their own injuries.