Unique Plan Description: Newborn Hypoglycemia Algorithm (JE FH)
Plan Selection Display: Newborn Hypoglycemia Algorithm (JE FH)
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2020-04-22 19:14:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2025-03-24 10:15:19
Available at all facilities: No

Newborn Hypoglycemia Algorithm (JE FH)
Diet
	Breast Milk
		Feed Frequency: Per Hypoglycemia Protocol, Feed Base: Mother Breast Milk, Route: Breast, If No Breast Milk: Donor Milk
Laboratory
	Glucose POC - RN
		T;N, Q3H, 3, Dose(s)/Time(s)
			Comment: AC-prior to feeding per Hypoglycemia Algorithm
IV Solutions
	Dextrose 10% intravenous soln (Bolus)
		2 mL/kg, Syringe, IV Push, Once, STAT
Medications
	glucose oral gel UD
		0.5 mL/kg, Gel, By Mouth, Q45MIN, PRN, blood glucose < (see comment), T;N, Duration: 2 Dose(s)/Time(s)
			Comment: For blood glucose <40
	glucose oral gel
		0.5 mL/kg, Gel, By Mouth, Q45MIN, PRN, blood glucose < (see comment), Duration: 2 Dose(s)/Time(s)
			Comment: For blood glucose <40
	sodium chloride 0.9% flush injectable soln (FH)
		1 mL, Syringe, IV Push, Q5MIN, PRN for IV line flush
	sodium chloride 0.9% flush injectable soln (NICU)
		1 mL, Syringe, IV Push, Q5MIN, PRN for IV line flush
Patient Care
	Newborn Glucose Management (JE/FH)
		T;N
			Comment: If glucose is >120 draw serum glucoseIf serum glucose is >120, Notify MD                                                        If any glucose value is <40, follow Newborn Hypoglycemia Algorithm (JE/FH) for feeding and follow-up management of blood sugars and enter Newborn Hypoglycemia Algorithm (JE/FH) PowerPlan By 24 hours of age, glucose POC value should be >/=50.  If not >/=50, notify MD.				   Newborn Hypoglycemia Algorithm1. Check initial blood glucose (40 minutes after START of feeding)	a. If Glucose result >/=40:		i. Feed every 2-3 hours following Hypoglycemia Protocol according to risk factors	b. If Glucose result 30-39:  		i. Administer oral glucose gel based on weight of infant		ii. Feed the baby			1. May breastfeed if asymptomatic			2. Give a minimum of 15 mL donor breast milk, pumped breast milk or hypoallergenic formula via bottle or gavage if symptomatic                                    or baby not latching and nursing well for at least 10 minutes				a. If parent requests formula:                                              	                                                        	1. Continue to use hypoallergenic formula with presence of risk factors or history of MSPI                                              			2. Use formula of provider's or mom's choice if no history of MSPI present                                   			3. May put back to breast after supplementation if breastfeeding				iii. Check second postprandial POC glucose 40 minutes after start of supplementation/feeding  					1. If second postprandial POC glucose >40:						a. Feed every 2-3 hours and continue with pre-prandial POC glucose every 2-3 hours x3. Follow Newborn Hypoglycemia Algorithm (JE/FH) as needed.   					2. If second postprandial POC glucose 30-39:						a. Administer oral glucose gel based on weight of infant						b. Feed the baby							i. Give a minimum of 15 mL donor breast milk, pumped breast milk or hypoallergenic formula via bottle or gavage							ii. May put back to breast after supplementation if breastfeeding						c. Check third postprandial POC glucose 40 minutes after start of supplementation						d. Notify MD					3. If second postprandial POC glucose <30:						a. Administer oral glucose gel based on weight of infant						b. Start IV D10W bolus 2 mL/kg						c. Feed the baby							i. Give a minimum of 15 mL donor breast milk, pumped breast milk or hypoallergenic formula via bottle or gavage							ii. May put back to breast after supplementation if breastfeeding						d. Check third postprandial POC glucose 40 minutes after start of supplementation						e. Notify MD  	c. If Glucose < 30:		i. Administer oral glucose gel based on weight of infant		ii. Start IV D10W bolus 2 mL/kg		iii. Feed the baby			1. Give a minimum of 15 mL donor breast milk, pumped breast milk or hypoallergenic formula via bottle or gavage if symptomatic                                    or baby not latching and nursing well for at least 10 minutes				a. If parent requests formula:                                              	                  			1. Continue to use hypoallergenic formula with presence of risk factors or history of MSPI                                            		2. Use formula of provider's or mom's choice if no history of MSPI present                                   			2. May put back to breast after supplementation if breastfeeding  		iv. Notify MD                  	v. Check second postprandial POC glucose 40 minutes after start of supplementation/feeding.			1. If second postprandial POC glucose > 40:				a. Feed every 2-3 hours and continue with pre-prandial POC glucose every 2-3 hours x3. Follow Newborn Hypoglycemia Algorithm (JE/FH) as needed.   			2. If second postprandial POC glucose 30-39:				a. Administer oral glucose gel based on weight of infant				b. Feed the baby					i. Give a minimum of 15 mL donor breast milk, pumped breast milk or hypoallergenic formula via bottle or gavage					ii. May put back to breast after supplementation if breastfeeding				c. Check third postprandial POC glucose 40 minutes after start of supplementation				d. Notify MD			3. If second postprandial POC glucose <30:				a. Administer oral glucose gel based on weight of infant				b. Start IV D10W bolus 2 mL/kg				c. Feed the baby					i. Give a minimum of 15 mL donor breast milk, pumped breast milk or hypoallergenic formula via bottle or gavage					ii. May put back to breast after supplementation if breastfeeding				d. Check third postprandial POC glucose 40 minutes after start of supplementation				e. Notify MD  2. After treatment of a POC glucose <40, all infants will have a minimum of 3 follow-up pre-prandial (AC) POC glucoses completed.	a. Enter order for pre-prandial (AC) POC Glucose every 2-3 hours x3, use the Newborn Hypoglycemia Algorithm (JE/FH) power plan              		i. If any pre-pr

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase