Hypoglycemia

High risk newborns for hypoglycemia

• LGA

• SMA

• GESTATIONAL DM

• cold stress

Why are infants at risk for hypoglycemia? (patho)

• In utero

  • glucose provided by placental transfer

• Umbilical cord cut

  • glucose halted

  • used liver glycogen & adipose tissue stores

Indications for an RN to conduct a neonatal accucheck

diabetic mom
Weight < 2500g or > 4000g
cold stress/hypothermia
meconium aspiration syndrome
hypoxia

Normal Glucose

40-60

Hypoglycemia glucose

<35

S/S of Hypoglycemia

• Lethargy

• Jittery

• Poor feeding

• Cyanosis

• Apnea

• Tachypnea

• high pitched/weak cry

• seizure

• hypertonia

• Temp instability

How are glucose levels obtained?

Heel sticks

Prevention of hypoglycemia

Maternal regulation of glucose levels

High maternal glucose level stimulates fetal pancreas to produce insulin

After birth maternal glucose is no longer available, yet pancreas is still secreting insulin

• PREVENT WITH FREQUENT FEEDING

Stable newborn found to be hypoglycemia on routine blood glucose check?

Enteral feedings started IMMEDIATELY

Check glucose in 30 mins

Infant glucose not responding to oral feedings?

IV glucose and glucose level monitored

Once regulated, wean infant