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 schedulewill be incorporated into the client’s daily routine7. 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
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
Time Required: 10 to 15 minutesHeres How:1.) First, set out your glucometer, a test strip, a lancet and analcohol prep pad.2.)Wash your hands to prevent infection.3.)Decide where you are going to obtain the blood from, usually afinger. Some of the newer monitors let you use your forearm oranother less sensitive place.4.)Sometimes it helps to warm your hands first to make the bloodflow easier. You can rub your hands together briskly or run themunder warm water.5.)Turn on the glucometer and place a test strip in the machinewhen the machine is ready. Watch the indicator for placing theblood to the strip.6.)Make sure your hand is dry and wipe the area youve selectedwith an alcohol prep pad and wait until the alcohol evaporates.
7.)Pierce your finger tip on the soft, fleshy pad and obtain a dropof blood. The type of drop of blood is determined by the type ofstrip you are using (some use a "hanging drop" of blood versus asmall 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 bloodsugar reading. Follow your doctors orders for whatever bloodsugar reading you get.10.)You may use the alcohol prep pad to blot the site where youdrew the blood if it is still bleeding.11.)Write down your results. Keeping a record makes it easier foryou and your doctor to establish a good treatment plan. Someglucometers can store your results in a memory, for easier recordkeeping.