Clinical Presentation & Protocol
Patient Usually Complains Of
Neonate presents with visible jaundice noted at [Age in hours/days]. Parents report [poor/adequate] feeding, [normal/dark] urine, and [normal/acholic] stools. No history of fever, lethargy, or respiratory distress. Maternal blood type [O/A/B/AB], Rh [+/-], and Coombs status [positive/negative].
Clinical Examination Findings
Infant is alert and active. Skin exam reveals cephalocaudal progression of jaundice (Kramer scale zone [1-5]). Sclerae icteric. Mucous membranes moist. Fontanelle soft and flat. Abdomen soft, non-distended, liver/spleen not palpable. No cephalhematoma or significant bruising noted. Neurological exam: tone normal, primitive reflexes intact.
Treatment Protocol
Plan: 1. Total Serum Bilirubin (TSB) and fractionated bilirubin levels. 2. Blood type, Rh, and Direct Coombs test. 3. Plot TSB on AAP nomogram to determine risk zone. 4. Initiate phototherapy if TSB exceeds threshold. 5. Optimize feeding (breastfeeding/supplementation) to promote stooling and bilirubin excretion. 6. Follow-up TSB in [6-12] hours.