A Newborn Boy Is Evaluated on Arrival in the Nursery

A newborn boy is evaluated on arrival in the nursery.  He was born 3 hours ago by spontaneous vaginal delivery at 40 weeks gestation after an uncomplicated pregnancy.  Apgar scores were 9 at 1 minute and 10 at 5 minutes after birth.  His mother has no significant medical history and does not take any medications.  Temperature is 36.7 C (98 F) , pulse is 124/min, and respirations are 26/min.  He is awake, alert, and active with a strong cry.  His head is normocephalic and atraumatic with an open flat anterior fontanelle.  Pupils are equal and reactive to light and accommodation, and red reflexes are present bilaterally.  The nares are patent, there is no cleft lip or palate, and the pharynx is not erythematous.  Clavicles are intact without crepitus.  S1 and S2 are normal without murmurs, and lungs are clear to auscultation bilaterally.  The abdomen is soft, nontender, and nondistended with normal bowel sounds and no organomegaly.  Femoral pulses are normal and symmetrical.  All extremities move spontaneously and there is no edema.  There are no rashes, skin lesions, or jaundice, but the complexion appears ruddy with generalized erythema.  Blood samples obtained from the heel through simple prick method reveal a hematocrit of 70%.
What is the most appropriate next step in management of this patient?

A) Check blood type and Coombs test
B) Check serum blood urea nitrogen and creatinine
C) Check thyroid function tests
D) Recheck the hematocrit by repeating heel prick
E) Recheck the hematocrit from peripheral blood

Correct Answer:

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