Nursing care management
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. Within the physical assessment, comorbidities of hypoglycemia should also be assessed such as intolerance of feeding, or respiratory distress. Another important nursing intervention is assisting the mother in successful breastfeeding as this can prevent and treat hypoglycemia.If an IV infusion of 10% dextrose in water is initiated then the nurse must monitor for:
•Circulatory overload•Hyperglycemia•Glycosuria•Intracellular dehydration

Outcomes
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. The severity of the effects resulting from the hypoglycemic episode depend on the length of the hypoglycemic episode and how low the neonates blood glucose levels drop during the episode. Because glucose is an essential nutrient for the brain, untreated neonatal hypoglycemia causes irreversible damage to both the posterior occipital and cortex regions of the brain. These areas function in cognition, adaptability, and visual skills.
Neonatal hypoglycaemia can be a stand-alone condition or a clinical manifestation of other conditions. Signs and symptoms
The way in which neonatal hypoglycemia symptoms may be presented is vague or hard to tell apart from other conditions. The symptoms can be confused with:

hypocalcemia
Sepsis
CNS disorders
Cardiorespiratory problemsNeonatal hypoglycemia can also show no symptoms in some newborns or may be life-threatening.Some observed symptoms are (these symptoms may be transient but reoccurring):

Jitteriness
hypothermia 
irritability 
pallor 
tremors
twitching
weak or high pitched cry
lethargy
hypotonia
generalized seizures
coma
cyanosis
apnea
rapid and irregular respirations
diaphoresis
eye rolling
refusal to feed
hunger

Causes
Risk Factors
Mother
Risk factors in the mother that increased the risk of developing hypoglycemia shortly after birth include:

Type 1 diabetes
Gestational diabetes mellitus (Transient)
Intrapartum glucose administration (Transient)
Gestational hypertension
Preeclampsia
Terbutaline administration (Transient)
Intrauterine growth restriction (Transient)
Perinatal stress or asphyxia (Transient)

Baby
Babies which have an increased risk of developing hypoglycemia shortly after birth are:

hypothermia (Transient)
polycythemia (Transient)
hyperinsulinism (Recurrent)
IEMs (Recurrent)
Beckwith-Wiedmann syndrome (Recurrent)
nesidioblastosis (Recurrent)
Rh isoimmunization (Recurrent)
Certain endocrine disorders (Recurrent)
fetal hydrops
Prematurity (Transient)
congenital malformations
small for gestational age (Transient)
Large for gestational age (Transient)

Hyperinsulinism
The most common cause on neonatal hypoglycemia is hyperinsulinism. Hyperinsulinism is also called persistent hyperinsulemic hypoglycemia of infancy (PHHI). This is seen very frequently to the neonates born from mothers with diabetes. Congenital hyperinsulinism is correlated with the abnormality of beta-cell regulation within the pancreas. Isolated islet adenoma, which is a focal disease, is often the cause of congenital hyperinsulism. Drug-induced hyperinsulisim is correlated with the administration insulin or use of hypoglycemic medication. In critical cases, a drug called Diazoxide is availed to stop any secretion of insulin. Limited glycogen stores
Limited glycogen storage occurs in premature newborns or newborns that had intrauterine growth retardation.