Renal failure case study

 CASE STUDY 2

This is a 1-day-old girl born at 26 weeks’ gestation via a spon-

taneous vaginal delivery 2 days following premature rupture

of membranes. Her birth weight was 750 g and her Apgar

scores were 5 and 6 at 1 and 5 minutes of life. She was intu-

bated and given surfactant. After a blood specimen was

drawn for culture, she was started on ampicillin and gentami-

cin and given maintenance intravenous (IV) fluid. She fails to

pass urine in the first 24 hours after birth, and her blood pres-

sures are persistently low at 30/20 mm Hg.

Questions

1. When should newborns pass the first urine after birth?

2. What should you do first to evaluate and treat this infant?

3. Is she at risk for gentamicin toxicity?