A TPN-dependent infant’s ionized calcium rises after treatme…
A TPN-dependent infant’s ionized calcium rises after treatment but falls again to 0.8 mmol/L. Magnesium is 0.8 mg/dL, phosphorus is 5.4 mg/dL, and pH is 7.37. Urine output has fallen to 0.4 mL/kg/hr and creatinine is rising. Which plan best addresses the recurrent mineral disturbance?
Read DetailsAn infant receiving medical treatment for NEC has rising lac…
An infant receiving medical treatment for NEC has rising lactate, falling platelets, falling serum sodium and new abdominal-wall erythema. Ventilator and vasoactive support requirements are increasing. Repeat abdominal radiographs show no free air. What is the next best action?
Read DetailsAn infant has substantial small-bowel loss after surgery for…
An infant has substantial small-bowel loss after surgery for NEC. Small human-milk feeds are tolerated, the abdomen is soft, and ostomy output is stable, but parenteral nutrition is still needed to meet nutrient requirements. Which feeding strategy best supports intestinal adaptation and growth?
Read DetailsA stable 3-day-old infant has abdominal distension, bilious…
A stable 3-day-old infant has abdominal distension, bilious gastric drainage, and has not passed meconium. The anus is patent and an upper GI study has excluded malrotation. There is no evidence of perforation or enterocolitis. Which study best evaluates the colon for abnormal caliber, a transition zone, or obstructing material?
Read DetailsA 26-week infant on day of life 3 is receiving total fluids…
A 26-week infant on day of life 3 is receiving total fluids of 120 mL/kg/day and has lost 12% of birth weight. Serum sodium has increased from 145 to 155 mEq/L over 12 hours and urine output is 5 mL/kg/hr. Blood pressure and perfusion remain reassuring. Review of all infusions confirms the ordered intake and no excessive sodium delivery. Which fluid adjustment should the NNP make?
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