Baby S is an African American male born at 24 weeks and 1 day gestation who is now 5 months of age. Baby was brought to

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Baby S Is An African American Male Born At 24 Weeks And 1 Day Gestation Who Is Now 5 Months Of Age Baby Was Brought To 1 (62.06 KiB) Viewed 17 times

Baby S Is An African American Male Born At 24 Weeks And 1 Day Gestation Who Is Now 5 Months Of Age Baby Was Brought To 2 (41 KiB) Viewed 17 times

Baby S is an African American male born at 24 weeks and 1 day gestation who is now 5 months of age. Baby was brought to your office by the mother who is found to be a reliable historian. This is his first visit to you following discharge from the NICU. The mother reports that the baby has been coughing for 1 week with a runny nose. Nasal secretions have been clear. His cough is worse. REVIEW OF SYSTEMS (Significant History) History of Pregnancy: Mother is a 21-year old African American that received prenatal care at north Central clinic. Mother denies any past medical history. Maternal labs were negative. Labor and Delivery: Mother was admitted in active labor and fully dilated. Baby was born via NSVD. Rupture of membranes was at delivery with clear fluid, Baby was intubated in the delivery room and transported to the NICU. APGAR score at 1 minute was 2, at 5 minutes 5 and at 7 minutes 7. Birth weight: 580 grams HC: 23 cm Length: 32 cm Current medications: Multivitamins and iron 1 ml QD Immunizations: Up to date. Baby has received 2 doses of Hepatitis B, 2 doses DTP, 2 doses IPV, 2 doses Prevnar, and 2 doses of HIB Social: He lives with both parents with an older sibling that is 2 years old. There is no smoking in the home. EENT: Mother denies any indication of ear discomfort or drainage. Nasal discharge as stated above. No difficulty in swallowing. Respiratory: The baby was intubated for 34 days. While he was intubated, he received 5 days of the DART protoc facilitate extubation. During his course of hospitalization, the baby received spironolactone, chlorothiazide, sodium chloride, Xopenex, caffeine and budesonide. Denies apnea. Cardiovascular: Diagnosed with pulmonary hypertension by ECHO on 8/29/2021. Baby has had serial ECHO studies the last being done on 11/25/2021 which showed a small PDA with left-to-right flow. Denies any co changes. GI: Mother denies any feeding problems. PHYSICAL EXAMINATION (Significant findings)
148 Current Weight: 3840 grams HC: 32 cm Length: 50 cm Vital signs: Temperature: 99 F Heart rate: Respiratory rate: 70 Blood pressure: 102/50 EENT: Mild nasal flaring noted Respiratory: Breath sounds equal bilaterally crackles upon auscultation. Mild intercostal retraction noted. Moist nonproductive cough present. Oxygen saturation at 96%. No wheezing noted. Cardio: Regular sinus rhythm with a loud systolic murmur. Capillary refill 3 seconds, What is your differential? What is your diagnosis? Rationale? Would any laboratory studies be valuable? What should have been given to this baby prior to discharge from the hospital? Rationale? Should the baby be hospitalized?