A 2-Day-Old Boy Is Being Evaluated in the Nursery

A 2-day-old boy is being evaluated in the nursery.  The patient was born at 39 weeks gestation via spontaneous vaginal delivery to a 17-year-old primigravida.  The pregnancy was complicated by lack of prenatal care.  The delivery was uncomplicated, and the patient had Apgar scores of 9 and 9 at 1 and 5 minutes, respectively.  He is formula-feeding well and has stooled twice but has had only a single wet diaper in the first 48 hours.  Weight is 2.89 kg (6 lb 6 oz) , down 3% from birth weight.  Physical examination is unremarkable.  Which of the following is the best next step in the evaluation of this patient?

A) Abdominal radiograph
B) Bladder catheterization
C) Continued observation
D) Intravenous fluid bolus
E) Renal and bladder ultrasound
F) Voiding cystourethrogram

Correct Answer:

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