Approach to complications of prematurity (early) Quiz: Ace Your Exams
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A 3-day-old newborn female in the Neonatal Intensive Care Unit (NICU) is being evaluated for hypotonia and decreased spontaneous movements. She was born at 28 weeks' gestation via spontaneous vaginal delivery for preterm labor and required immediate resuscitation and intubation. There was no history of maternal fever, and maternal labs are within normal limits. There has been no fever, vomiting, or bloody stools. Temperature is 36.8°C (98.2°F) and stable, pulse is 168/min, respirations are 38/min, blood pressure is 52/28 mm Hg, and oxygen saturation is 98%. On physical exam, the patient is intubated, hypotonic and has decreased spontaneous movements. The anterior fontanelle is open and flat. Heart sounds are normal, and there is no murmur. Lungs are clear with equal air entry bilaterally. Abdominal exam is unremarkable. Nasogastric tube and umbilical lines are in place. The newborn is tolerating appropriate volumes of nasogastric and parenteral nutrition. Labs are shown below. Which of the following findings would confirm the most likely diagnosis?
| Laboratory value | Results |
| Hemoglobin | 12 g/dL |
| Hematocrit | 36% |
| White blood cells | 8,000 /mm3 |
| Platelets | 130,000/mm3 |
| Sodium | 136 mEq/L |
| Potassium | 4.8 mEq/L |
| PH | 7.35 |
| PCO2 | 39 mmHg |
| Bicarbonate (HCO3) | 22 mEq/L |
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