Measuring Blood Glucose Levels (CBG)

Assessment: 1. Review the physician’s order for glucose monitoring

2. Identify which type of equipment is available at your facility

3. Review the client’s medical history for diabetes, any visual impairment, oral anticoagulant therapy

4. Determine if the test requires special timing, (Before or after meals)

5. Assess the client’s or caregiver’s ability to manage the equipment and perform the test accurately if the care will be provided at home

6. Assess the client’s understanding of the rationale for the test and the importance of accurate results. Determine the client’s willingness to perform the test schedule will be incorporated into the client’s daily routine

7. Assess the client’s sites for skin puncture

Nursing Diagnosis:

-Anxiety or fear related to the procedure of skin puncture

-Anxiety related to a diagnosis of diabetes

-Risk for Impaired Skin Integrity related to the diagnosis

-Disturbed Sensory Perception related to visual acuity or sensorium

Planning: Expected Outcomes

1.Blood glucose level is maintained within a normal range

2.Client or caregiver demonstrate accurate performance of the procedure

3.Client verbalizes an understanding of the importance of the test and the need for accurate results

4.Client verbalizes minimal anxiety associated with the procedure

5.Skin puncture site remain free of signs and symptoms of infection

Equipment Needed

• Reagent strips

• Disposable Gloves

• Lancet or automatic lancing device

• Paper towels

• Alcohol wipe

• 2x2 gauze

• Cotton ball

• Blood glucose meter

Implementation

Evaluation:

-Reinspect the puncture site for bleeding or tissue injury

-Compare the glucose reading with client’s previous glucose results

-Compare the client’s results with normal blood glucose levels -Ask the client to explain the importance of the results

-Ask the client to return demonstrate the procedure with the next scheduled test

Documentation: -Glucose test results

-Procedure and site used

-Appearance of the puncture site

-Client’s response to the procedure(headache ,nausea, etc)

-Abnormal results reported to the physician

-Client’s understanding of the procedure and ability to the technique

-Medication record

-Date and time insulin was administered

Glucometer

Time Required: 10 to 15 minutesHere's How:

1.) First, set out your glucometer, a test strip, a lancet and an alcohol prep pad.2.)Wash your hands to prevent infection.3.)Decide where you are going to obtain the blood from, usually a finger. Some of the newer monitors let you use your forearm or another less sensitive place.4.)Sometimes it helps to warm your hands first to make the blood flow easier. You can rub your hands together briskly or run them under warm water.5.)Turn on the glucometer and place a test strip in the machine when the machine is ready. Watch the indicator for placing the blood to the strip.6.)Make sure your hand is dry and wipe the area you've selected with an alcohol prep pad and wait until the alcohol evaporates.

7.)Pierce your finger tip on the soft, fleshy pad and obtain a drop of blood. The type of drop of blood is determined by the type of strip you are using (some use a "hanging drop" of blood versus a small drop for strips that draw blood in with a capillary action).8.)Place the drop of blood on or at the side of the strip.9.)The glucometer will take a few moments to calculate the blood sugar reading. Follow your doctor's orders for whatever blood sugar reading you get.10.)You may use the alcohol prep pad to blot the site where you drew the blood if it is still bleeding. 11.)Write down your results. Keeping a record makes it easier for you and your doctor to establish a good treatment plan. Some glucometers can store your results in a memory, for easier record keeping.