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.
Once SO is developed, immunosuppressive therapy is the mainstay of treatment. When initiated promptly following injury, it is effective in controlling the inflammation and improving the prognosis. Mild cases may be treated with local application of corticosteroids and pupillary dilators. More severe or progressive cases require high-dose systemic corticosteroids for months to years. Patients who become resistant to corticosteroids or develop side effects of long-term corticosteroid therapy (osteoporosis and pathologic fractures, mental status changes, etc. ), may be candidates for therapy with chlorambucil, cyclophosphamide, or ciclosporin. Epidemiology
Sympathetic ophthalmia is rare, affecting 0.2% to 0.5% of non-surgical eye wounds, and less than 0.01% of surgical penetrating eye wounds. There are no gender or racial differences in incidence of SO. History
Although descriptions of sympathetic ophthalmia can be found in ancient Greek texts, modern understanding of SO derives from the works of Scotlands William MacKenzie who characterized and named the disease sympathetic ophthalmitis. At MacKenzies time, oral mercury and leeches applied to the conjunctiva were the treatments of choice for SO.It is thought that Louis Braille, who injured one of his eyes as a child, lost vision in his other eye owing to SO. James Thurbers adult blindness was also diagnosed as sympathetic ophthalmia deriving from the loss of an eye when he was six years old. See also
Vogt–Koyanagi–Harada disease

References


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