Blood Glucose Monitoring Ppt

5/26/2018 Blood Glucose Monitoring Ppt

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Blood Glucose Monitoring

NUR 302Developed by:

Susan L Shelton RN, MSN, CNM

Revised by:

Jill Ray RN, MSN


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Measures blood glucose levels for monitoring control of

diabetes mellitus.

Test results direct

Diet

Amount and type of medication

Exercise prescription

Helps prevent diabetic emergencies by prompt detection &

treatment of hypo- & hyperglycemia


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Generalizations

Performed usually ac and hswhat does that mean?

Why should the BGL be assessed before a meal?

Each facility has a slightly different procedure. You will have to bevalidated at ea facility for this procedure.

Know the Normal values for blood glucose.

Report values outside of the range of normal ASAPvery important asimmediate intervention is usually indicated.

You will usually repeat the test if you get a value outside of the range of

normal. Know the values at which the monitor you are using is no longer accurate:

GMC less than 40 and greater than 300).

If the BGL if less than 90 you MUST intervene immediately. Dont wait onyour clinical instructor to come to youfind her or another RN.

See p. 1476 and 1477 for very good instructions re: this procedure.


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Whoa, Nelly.What is Diabetes????

Inability of the pancreas to either produce

enough insulin or the bodys inability to utilize

the insulin it has.

Insulin is the substance that converts glucose

to a form that is usable by the body.

Thus, low insulin equal high glucose

circulating in the blood but not

utilized by the cells.


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Hypoglycemia

vs.

Hyperglycemia

Hypoglycemia

Low blood sugar

hyperinsulinemia

Hyperglycemia

Elevated blood sugar

Inadequate insulin


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Hypoglycemia

Sweating

Tachycardia

Palpitations

Nervousness

Tremors

Weakness

Headache

Mental confusion

Fatigue


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Hyperglycemia

Thirst

Polyuria

Polyphagia

Weakness

Fatigue Headache

Blurred vision

Nausea

Vomiting Abdominal cramping


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So What?Complications of Abnormal Blood Glucose

Heart attack

Cerebrovascular accident

Kidney dysfunction Blindness

Nerve damage


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Goals for Glucose Control

Normal GoalIntervention

needed

Fasting

Glucose


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ASSESSMENT

Clients understanding

Health history

Specific conditions of specimen collection

Site selection

Clients ability to self-test

Presence of signs & symptoms glucose

alteration

Calibration of equipment


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PLANNING

Expected outcomes focus

on minimizing tissue

damage with finger stick,

achieving accurate results,

and maintaining glucoselevels within goal range.

Equipment

Glucometer

Gloves

Antiseptic swab

Cotton ball or gauze

Sterile lancet

Paper towel

Sharps box

Test strips


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IMPLEMENTATION

Wash hands

Position site lower than heart

Gather supplies and turn on meter

Select site and cleanse

Position lancet firmly against site and pierceskin

Collect sample

Read results


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IMPLEMENTATION

Once results are available,

Appropriate intervention for the value obtained,

then:

dispose of used supplies

document results

turn meter off (enter comments as indicated)


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Hypoglycemic Protocols

All hospitals will have these

Need to be familiar with this for your facility

before you begin to do this procedure.

Note that you must be supervised by an RN,

and can only perform those skills that you

have been validated for in the skills lab.


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EVALUATION

Observe site for bleeding or bruising

Compare client readings with normal values

Ask client to discuss procedures & test results Observe client performing self-testing


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But, what if?

Puncture site continues to bleed

Glucose meter malfunctions

Result is above or below normal value Client expresses misunderstanding of

procedure or results


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DOCUMENTATION

SAMPLE:

0730 Blood glucose 110. No insulin required.

1200 Blood glucose 240. Regular insulin (4 units)

given subcutaneously per sliding scale order.

**Some facilities have a flowsheet and others noteresults on MAR.


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Gwinnett Hospital System

Title: Precision PXP Glucose Meters

Competency

Statement:Demonstrates

management of the Precision PXP

glucose meter for patient testing ina safe

and effective manner.

Learning Resources:Precision

Xceed Pro (PXP)Manual- Abbott Co.

2007


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Performance CriteriaCritical Behaviors

Criteria

Met

Criteria

Not Met

CONTROL TEST

1. Press ON/OFF to turn on meter. Select #2-Control Test.

2. ScanOperator ID. ScanControl Solution lot #. Scanstrip lot #.

Make sure expirationdates are on control bottles. Use Expiration labels

in meter box.Controls are good for 90 daysonce opened

3. Open test strip foil packet, insert lined end of strip into meter through the

yellow port protector opening. Gently mix control solution and apply solution

by touching the drop of control to the white target area at the tip of the test

strip while meter is in a horizontal position the entire time. KEEP YELLOW

PORT PROTECTOR ON AT ALL TIMES

4. Monitor will start reading and beep when completed.5. Pass/Failwill appear on the screen . Failed controls must be documented

with a Comment Code; #1- Repeat Test. Controls must Pass before

proceeding to Patient Testing. See Troubleshooting below.

TROUBLESHOOTING OUT OF RANGE CONTROLS:

1. Check for air bubbles in nozzle of control solution or on test strip.

2. Check room temp. or humidity.3. Check storage of strips (3986 F)

4. Ensure bottles of control solution not opened > 90 days and not expired.

Check solution level.

5. Repeat testcontact lab if results continue to FAIL.


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PATIENT TESTING

1. Washes/cleanses hands. Wears gloves.

2. Select #1Patient Test. ScanOperator ID.

4. Scanthe Account # on the patients armband. Scanstrip lot #.

6. Select sample type (capillary/arterial or venous).

7. Open test strip foil packet and insert lined end of strip into meter through the opening onyellow port protector. AGAIN, KEEP YELLOW PORT PROTECTOR ON AT ALL

TIMES

8. Cleanse puncture site with alcohol, allow to dry, and wipe away first drop of blood with cotton

ball.

9. Apply free flowing blood sample by holding the finger to the white target area at the tip of the

test strip.

The blood is drawn into the target area.

10. Monitor will start reading and beep when results are ready.

( A or will appear in front of a value that is out of range; 400 for Adults; 200 for neonates/newborns, a Comment Code must be entered). All panic values are

immediately repeated using the same puncture site, if possible, for verification of initial

result. If result is still critical, enter appropriate Comment Code. See unit specific

instructions for hypoglycemic/hyperglycemicprotocols.11. Discard contaminated material in a biohazard disposal container.

12. Knows normal adult glcucose reference range at GHS is 60-99 mg/dL

13. Knows basic troubleshooting of patient test results (possible results w/ severe dehydration,

DKA,HHNS,ect)

14. Knows why and how often the meter must be DOCKED in the docking stations

State process for blood glucose monitoring of patient in isolation

Documents

Blood Glucose Monitoring Ppt