Sorry, I'm on a roll today and recovering from the large lumps on my head
from hitting it against the wall!!!!
Can anybody tell me what the normal specific gravity's of urine are for a one
day old and then second day and then third day?  I would assume since the
volumes are small on the first couple of days and the kidneys are concentrating
the urine with uric crystals normal up to 5 days old, that specific gravity
would also be different.
I was taking care of a full term baby, who at 40 hours old was admitted to
the Special Care Nursery with irritability, pallor, cyanosis around the lips
(sorry can't remember the term), blood tinge urine, elevated sodium, and temp of
99 rectally.
Up to this time the baby had been nursing well, had 4 voids and 4 stools.
When I came into work today I had learned the baby was in the unit, this all
happened after I left yesterday.  The neonatologist told me the baby was
dehydrated and that is why it was there.  I asked how could a 40 hour old baby get
dehydrated and she just said because of the elevated sodium and high specific
gravity that was the diagnosis.  I don't remember what she said the sp. gravity
was.  The doctor went on to say that a baby this age should be having 8 wet
diapers a day.  I said that what the literature states the norm on the first day
is one void and then just two voids on the second day.  She wouldn't hear me
nor would she give me her reference.  She also was telling me that the baby was
having apnea spells while feeding therefore the mother could not breastfeed
any more and only the nurse could give bottles (of formula because they wanted
60cc) while they did blow by oxygen.  I pointed out that bottle feeding would
be more hazardous to this baby and asked why not tube feedings and both the
doctor and nurse looked at me like I had 2 heads. (This is when I started
hitting my head against the wall!)  I asked if the baby was septic and was told the
white count was normal but waiting on the results of the spinal tape.  By the
time I left today the baby was NPO, on an IV and on O2.  The mother is pumping
and getting 30-40cc per pumping.  Mom was negative for Beta strep.
My feeling is that this baby became septic somehow and some of the signs of
dehydration resulted because of this.  If someone can help me with the specific
gravity question I would really appreciate that.  Also, other than
dehydration what would cause the sodium to be elevated, it was 155?
Thanks for any help.
Ann Perry RN IBCLC
Boston, MA

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