When monitoring a 1-hour-old newborn for hypoglycemia, which of the following findings should the nurse monitor for?

Monitoring a newborn for hypoglycemia involves observing specific signs that indicate the infant may be experiencing low blood sugar levels. One of the hallmark findings associated with hypoglycemia in neonates is neurological instability or irritability, which can present as twitching or tremors. These manifestations occur due to the brain’s sensitivity to decreased glucose levels, which are crucial for its function.

The presence of hypothermia is also significant, as newborns with hypoglycemia might not be able to maintain their body temperature effectively. Thus, the combination of hypothermia and twitching is a critical indicator that the newborn may be at risk for or currently experiencing hypoglycemia. These physiological responses reflect the body's attempt to react to insufficient glucose supplies.

The other options provided focus on symptoms that are not directly linked to hypoglycemia. For instance, fever and lethargy may suggest an infection or other underlying conditions, while nasal congestion and coughing point towards respiratory concerns. Bradycardia and vomiting might indicate other serious issues but are not specifically symptoms of hypoglycemia in a newborn. Thus, focusing on hypothermia and twitching directly addresses the signs that are most relevant to hypoglycemia monitoring in a 1-hour-old newborn.