Neonatal Jaundice

Question 1

CLERKING A CASE OF NEONATAL JAUNDICE (NN.J)
Case : A 4 day old neonate was brougnt in by mother with complains of yellow eyes and skin from second day of birth
Take a focused history from the mother

Answer 1

1. GRIP: (Greet, create Rapport, Introduce yourself, obtain Permission)
   Good morning ma. How are vou today? My name Is Or “**””
   Tam a candidate for the ongoing MDC exams. hor the
   purpose of mv exams. have been asked to take a histon
2. Biodata: NASORATI (Name, age and sex of child occupation, Religion, tribe and address or parents,
   informan-what’s vour relationship with this child ?

Question 2

PC and doctor

Answer 2

4. History of presenting complaints (HxPC): 5C’s - complaints, course, cause, complications, care so far
   a.b) DOCTOR
   Duration: -When was it first noticed?
   -was it present at birth or it started later
   Onset: How was it noticed? (gradual or sudden onset?)
   Course: Has it been worsening or improving?
   Character: IS It more noticeable on the face, eyes or whole body?
   Timing:
   Other symptoms/Related phenomenon:
   Has baby been feeding well?
   Any changes in baby’s activity level, such as excessive sleeping and irritation.
   Any difficult breathing or episodes of stopping breathing
   Any fever. vomiting or diarrhea. delayed bowel movement?

Question 3

Causes

Answer 3

-Was baby born at term or premature? (r/o prematurity)
-VoGe
-Were there any complications during delivery or use of forceps? (ro cephalohematoma)
-Is baby exclusively breast fed or formular fed? ( r/o breast milk/feeding jaundice)
How often IS child
-Does baby latch well during feeds and any refusal to feed? (r/c breastfeeding jaundice)
-Has baby passed stool since delivery? s stoo pale? (r/o delayed passage of meconium.)
-An changes in urine colour- dark urine?
-Was mother on any drugs during pregnancy like suphonamides, septrin?
-was this child exposed to camphor? r/o naphthalene poisoning)
-Any Illnesses during pregnancy?
-were you screened for Infections like hepatitis B,syphilis or HIV during pregnancy
-What is your blood group? O blood group or Rh - (ABO and Rh compatibility)

Question 4

Complications

Answer 4

-Hx of excessive sieepiness
-Episodes of high pitched cry or abnormal crying?
-Have you noticed seizures or abnormal body movement
-Any difficulty breathing?

Question 5

Care so far:

Answer 5

What did you do at home? Did you use an home remedies or herbal concoction?
Hospitals visited?
Investigation done: total serum bilirubin. Coomb’s test. FBC

Question 6

Prenatal. Natal and Post natal hx:

Answer 6

Prenatal: Was pregnancy desired, did you attend ANC?
Any hx of fever or rash during pregnancy?
how longdid you carry pregnancy?
Natal: Mode of delivery? If C/S - why?
IT vaginal: -Duration or labour? Use or Instrumentation like forceps or vacuum?
Post natal: Did cry immediately after birth? Birth weight? was baby admitted after deliver:

Question 7

Immunization and drug history

Answer 7

Immunization hy• Has baby received reguired birth immunization? OPV, BCG and Hep B vaccines?
7. Drug hx:
-was baby placed on any medications?

Question 8

Family and social history

Answer 8

Family and social hx:
-Any hx of similar condition in siblings at births:
-Number of children in family ?
-Living condition of family - How man windows in a room?
• Occupation of parents?
-Does any family member smoke at home?

Question 9

Review of system

Answer 9

Review of systems: Head to toes
Head: convulsion/abnormal body movement? Excessive sleeping
Chest: Cough, difficulty breathing
Abdomen: Abdominal distention. vomiting. diarrhea
Skin: Rash. dryness
Upper & lower limbs: is child flaccid? Or joint stiffness?
THANK YOU!