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Na Ii Ppt Finger Stick Blood Sugar Copy


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  • 1.  
  • 2.  
  • 3. Diabetes Mellitus
    • Diabetes Mellitus (DM): a disease where the body cannot use glucose normally to meet the energy needs of the body
    • In people over 65, 1 in 20 require treatment
    • Insulin is produced in the pancreas. During this disease process, usually the beta cells of the pancreas cease to function properly.
    • Two Main Types of Diabetes:
    • Insulin-dependent diabetes mellitus (IDDM) (Type 1)
    • Non-insulin-dependent diabetes mellitus (NIDDM) (Type 2)
  • 4. Diabetes Mellitus
    • IDDM:
    • In this disease, the beta cells of the pancreas are damaged and can not produce or don’t produce enough insulin
    • Insulin is required for the metabolism of glucose
    • With no insulin, the glucose can not be absorbed by the cells for energy, and accumulates in the bloodstream.
    • Most often seen in younger people
  • 5. Diabetes Mellitus
    • NIDDM:
    • In this disease, insufficient insulin is produced or the body ignores the insulin
    • This results in glucose not being absorbed by the cells and the glucose accumulating in the blood stream.
    • Also known as old-age diabetes
    • This form is more stable than IDDM with fewer incidents of diabetic coma or insulin shock
  • 6. Diabetes Mellitus
    • Signs and Symptoms:
    • IDDM:
    • Abrupt onset
    • Polydipsia- excessive thirst
    • Polyuria- excessive urination
    • Polyphagia- excessive hunger
    • Glycosuria-sugar in the urine
    • Hyperglycemia- excessive sugar in the bloodstream
  • 7. Diabetes Mellitus
    • NIDDM:
    • Patient is usually over weight with a sore or infection and possibly constant fatigue
    • Fatigues easily
    • Skin infections/ slow to heal
    • Itching
    • Burning on urination
    • Pain in fingers and toes
    • Vision changes
  • 8. Diabetes Mellitus
    • Complications of DM:
    • Renal Failure
    • Vision Changes
    • Cardiovascular Damage
    • Hyperglycemia
    • Hypoglycemia
  • 9. Diabetes Mellitus
    • Renal Disease:
    • A build up of glucose in the bloodstream damages all vessels and organs.
    • The crytals are very damaging
    • Note increased itching due to the inability of the kidneys to remove toxins from the bloodstream
    • Burning up urination is noted due to the glucose build up in the urine being caustic to the internal organs.
  • 10. Diabetes Mellitus
    • Vision Changes
    • Common in long term diabetes
    • Glaucoma-increased intraocular pressure resulting in atrophy of the optic nerve
    • Cataracts- an opacity of the lens of the eye usually occurring as a result of aging, trauma, endocrine or metabolic disease
    • Retinitis proliferans- inflammation of the retina marked by masses of connective tissue that project from the retina into the vitreous
    • Blindness-caused by diseases of the lens, the retina or the eye structures; diseases of the optic nerve; or lesions of the visual cortex or pathways of the brain
  • 11. Diabetes Mellitus
    • Cardiovascular Damage:
    • Heart Attacks
    • Strokes
    • Peripheral Vascular Disease (PVD)
    • Amputation
    • Vascular changes can interfere with the normal circulation to the legs and feet
    • Damage may be so extensive that the tissues of the toes, feet, and legs may die
    • Gangrene followed by amputation is common
  • 12. Diabetes Mellitus
    • Hyperglycemia- occurs when too little insulin is available for metabolic needs
    • Sugar and acid compounds (ketones) build up in the blood Known as diabetic ketoacidosis (DKA)
    • Can lead to death
    • Sugar and Ketones can spill over into the urine
    • First Symptoms:
    • Headache
    • Confusion
    • Drowsiness
    • Irritable
  • 13. Diabetes Mellitus
    • Treatment of Hyperglycemia:
    • Immediate tx is insulin and fluids given intravenously by the nurse
    • Report to the nurse immediately if you notice:
    • Increased thirst
    • Complaints of vision changes
    • Complaints of nausea or vomiting
    • A sweet odor to the breath
    • Dry, flushed skin
  • 14. Diabetes Mellitus
    • Hypoglycemia -low blood sugar
    • Can be a result of an overdose of insulin known as Insulin reaction or Insulin Shock
    • Can also be a result of :
    • Not eating enough at the right time
    • Unusual activities
    • Vomiting
    • Diarrhea
    • Interaction of medications
  • 15. Diabetes Mellitus
    • Signs and Symptoms:
    • Hunger
    • Sweating
    • Dizziness
    • Confusion
    • Erratic Behavior
    • Pale moist skin
    • Staggering gait
    • Drowsiness
  • 16. Diabetes Mellitus
    • Treatment is:
    • Sugar in some form
    • A food containing sugar if the resident is conscious
    • An Injection of glucagon if the patient is unconscious
    • Orange Juice or other easily absorbed source of sugar should be kept accessible for emergencies
  • 17. Finger Stick Blood Sugar
    • Fingerstick Blood Sugar (FSBS):
    • Used by those with DM to monitor sugar levels in the blood
    • Used to determine dosage requirements of antidiabetic medications
    • Residents who experience emotional stress or have an infection of any kind are at greater risk for imbalance
  • 18. Finger Stick Blood Sugar
    • FSBS:
    • Is checked by collecting a sample of capillary blood with a lancet
    • Transferring the blood sample to a regent strip
    • Reading the visual results
  • 19. Finger Stick Blood Sugar
    • There are many different types of glucometers (meters used to measure the glucose) available
    • Glucometers use a test strip in place of the reagent strip
    • Glucometers will usually give a digital readout of the glucose level
    • Each glucometer and its test strips are different, you will need to know how to properly operate your device before approaching the patient for a sample
  • 20. Finger Stick Blood Sugar
    • FSBS:
    • The MD will order specific times for blood sugar testing usually before meals
    • The MD may also order Two-hour post-prandial blood sugars (PPBS)- this sample is to be collected exactly two hours after the patient finishes eating
    • After meals, the blood sugar should be elevated but within two hours after eating, should return to normal
    • The RN can also instruct you to get a FSBS now, if a patient is displaying S/S of a diabetic upset
  • 21. Finger Stick Blood Sugar
    • Normal Blood Levels:
    • These can vary from facility to facility
    • The normal range is usually between 65 and 120
    • Normal value being 70-110
    • Notify the RN immediately if you obtain a value higher or lower than the normal range
    • Most glucometers have a small range. If the value obtained is below 40 the meter will read “low” and if the value obtained is higher than 500, the meter will read “high”. Report to the RN immediately.
  • 22. Finger Stick Blood Sugar
    • Glucometers:
    • Must be calibrated daily or per facility policy
    • Calibration is done to ensure meter accuracy
    • Calibrating is completed by running a test using a special test strip or by using a liquid control solution
    • The results must be within a specified range and must be documented on a log
    • Do not use a meter until it has been calibrated
  • 23. Finger Stick Blood Sugar
    • Procedure:
    • Equipment:
    • Observe Standard Precautions
    • Alcohol swab
    • Lancet
    • Glucometer
    • Test Strips for that specific glucometer
    • Sharps container
  • 24. Finger Stick Blood Sugar
    • Procedure:
    • Explain the procedure to your patient
    • Wipe the patient’s finger with the alcohol wipe and allow to dry
    • Pierce the side of the middle or ring finger using the lancet
    • Place the lancet in the sharps container
    • Squeeze the sides of the finger gently to obtain a drop of blood
  • 25. Finger Stick Blood Sugar
    • Hold the puncture site directly over the reagent strip and place a hanging drop of blood onto the reagent pad.
    • Insert the strip into the meter if this was not done previously
    • Wipe the finger with the alcohol swab and allow to dry.
    • Apply pressure until bleeding stops
    • Apply bandage if necessary
    • The meter should beep with completed with reading
  • 26.  
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