[2] Age, birth weight, metabolic needs, and wellness state of the newborn has a substantial impact on their blood glucose level.
[2] In critical cases, a drug called Diazoxide is availed to stop any secretion of insulin.
[2] Major causes of increased glucose use in a newborn include hyperthermia, polycythemia, sepsis, and growth hormone deficiency.
Neonatal hypoglycemia occurs because an infants brain is dependent on a healthy supply of glucose.
One way of screening includes a heel stick to test the blood glucose level at the bedside.
These specimens are either taken from the heel, arterial, or venous punctures and must be store immediately on ice in order to prevent glycolysis, further altering the results.
[1] Guidelines in the UK, however, recommend pre-feed screening of at-risk infants at 2–4 hours of age (to avoid false positives when blood glucose is, ordinarily, at its lowest at 2–3 hours of age) and at the subsequent feed until a blood glucose level of >2.0 mmol/L (36 mg/dL) on at least two consecutive occasions and is feeding well.
Following the mini bolus a continuous infusion of 10% dextrose in water at 80-100 mL/kg/day in order to maintain a healthy serum glucose level between 40 and 50 mg/dL.
[1] The biggest nursing concern for a neonate experiencing hypoglycemia is the physical assessment to potentially find the cause.
It is also essential to prevent environmental factors such as cold stress that may predispose the newborn for further decreasing blood sugar.
Another important nursing intervention is assisting the mother in successful breastfeeding as this can prevent and treat hypoglycemia.
[1] If an IV infusion of 10% dextrose in water is initiated then the nurse must monitor for: •Circulatory overload[1] •Hyperglycemia[1] •Glycosuria[1] •Intracellular dehydration[1] Infants that experienced hypoglycemic episodes requiring treatment within the first few days of life have a higher chance of developing neurological or neurodevelopmental diagnoses than normoglycemic infants.
[8] Long term complications of neonatal hypoglycemia may include: Continuous glucose monitoring devices have been suggested to be helpful for improving blood glucose monitoring in neonatal infants, however, the devices have not been approved for use in this age group and the potential benefits and risks are not clear from available studies.