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Blood Glucose Monitoring

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Blood Glucose Monitoring NUR 302 Developed by: Susan L Shelton RN, MSN, CNM Revised by: Jill Ray RN, MSN * * * * * Remember U is NOT permitted per JACHO. – PowerPoint PPT presentation

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Title: Blood Glucose Monitoring


1
Blood Glucose Monitoring
  • NUR 302
  • Developed by
  • Susan L Shelton RN, MSN, CNM
  • Revised by
  • Jill Ray RN, MSN

2
Blood Glucose Monitoring
  • 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

3
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 be validated at ea facility for
    this procedure.
  • Know the Normal values for blood glucose.
  • Report values outside of the range of normal
    ASAPvery important as immediate 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 on your clinical
    instructor to come to youfind her or another RN.
  • See p. 1476 and 1477 for very good instructions
    re this procedure.

4
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.

5
Hypoglycemia vs.Hyperglycemia
  • Hypoglycemia
  • Low blood sugar
  • hyperinsulinemia
  • Hyperglycemia
  • Elevated blood sugar
  • Inadequate insulin

6
Hypoglycemia
  • Sweating
  • Tachycardia
  • Palpitations
  • Nervousness
  • Tremors
  • Weakness
  • Headache
  • Mental confusion
  • Fatigue

7
Hyperglycemia
  • Thirst
  • Polyuria
  • Polyphagia
  • Weakness
  • Fatigue
  • Headache
  • Blurred vision
  • Nausea
  • Vomiting
  • Abdominal cramping

8
So What?Complications of Abnormal Blood Glucose
  • Heart attack
  • Cerebrovascular accident
  • Kidney dysfunction
  • Blindness
  • Nerve damage

9
Goals for Glucose Control
Elkin et. al (2004, 3rd Ed.), Table 14-1, p.361
10
Blood Glucose MonitoringASSESSMENT
  • 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

11
Blood Glucose MonitoringPLANNING
  • Expected outcomes focus on minimizing tissue
    damage with finger stick, achieving accurate
    results, and maintaining glucose levels within
    goal range.
  • Equipment
  • Glucometer
  • Gloves
  • Antiseptic swab
  • Cotton ball or gauze
  • Sterile lancet
  • Paper towel
  • Sharps box
  • Test strips

12
Blood Glucose MonitoringIMPLEMENTATION
  • Wash hands
  • Position site lower than heart
  • Gather supplies and turn on meter
  • Select site and cleanse
  • Position lancet firmly against site and pierce
    skin
  • Collect sample
  • Read results

13
Blood Glucose MonitoringIMPLEMENTATION
  • Once results are available,
  • Appropriate intervention for the value obtained,
    then
  • dispose of used supplies
  • document results
  • turn meter off (enter comments as indicated)

14
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.

15
Blood Glucose MonitoringEVALUATION
  • Observe site for bleeding or bruising
  • Compare client readings with normal values
  • Ask client to discuss procedures test results
  • Observe client performing self-testing

16
Blood Glucose MonitoringBut, what if?
  • Puncture site continues to bleed
  • Glucose meter malfunctions
  • Result is above or below normal value
  • Client expresses misunderstanding of procedure or
    results

17
Blood Glucose MonitoringDOCUMENTATION
  • 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
    note results on MAR.

18

Gwinnett Hospital System Title

Precision PXP Glucose Meters Competency
Statement Demonstrates management of the
Precision PXP glucose meter for patient testing
in a safe
and effective
manner. Learning Resources Precision Xceed Pro
(PXP)Manual- Abbott Co. 2007
19
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