UNIT 12b Blood Glucose

Exam focus: Based on your exam blueprint, Blood Glucose Testing is listed for 2 questions. Prioritize the normal fasting range, when to test, causes of hyperglycemia versus hypoglycemia, and the treatments listed in your slides.

What are the five learning objectives for capillary blood glucose testing?

Differentiate bedside and laboratory testing; identify indications; recognize assessment findings and appropriate testing times and sites; demonstrate proper glucometer technique; interpret results and implement nursing interventions

What is bedside blood glucose testing?

Blood glucose testing performed at the bedside by an RN or trained UAP

What is venous blood glucose testing?

Laboratory testing using a venous blood sample; provides a more accurate measurement to confirm abnormal bedside readings

What is the normal fasting blood glucose range in the slides?

74–106 mg/dL

When should abnormal bedside glucose results be confirmed with venous testing according to the slides?

When the bedside result is below 60 mg/dL or above 400 mg/dL

What is the purpose of bedside blood glucose testing?

Monitor glucose levels; maintain stable blood glucose; identify abnormalities early; reassess interventions

How can blood glucose testing evaluate the effects of activity?

Compare glucose levels around activity to evaluate how activity affects blood glucose

When should blood glucose be checked to evaluate the effects of meals according to the slides?

Approximately 1½ hours after meals

What does p.c. mean?

After meals

When should blood glucose be checked to evaluate insulin or other diabetes medications?

Before meals and at bedtime

What does a.c. mean?

Before meals

What does HS mean?

At bedtime

What are common times to perform bedside blood glucose testing?

Before meals; at bedtime; when consciousness changes; during emergencies; according to facility policy

When should blood glucose be checked if a client has a change in level of consciousness?

Check blood glucose to assess for a possible glucose abnormality

When may blood glucose testing be needed during an emergency?

During emergency situations such as cardiopulmonary arrest

What special site is preferred for capillary glucose testing in infants?

The outer aspect of the heel

What should the nurse do before puncturing a site with poor peripheral perfusion?

Warm the site to encourage blood flow

Which sites should be avoided for capillary blood glucose testing?

Previous puncture sites; inflamed areas; bruised areas; edematous areas; infected areas; cyanotic or cold tissue; poorly perfused tissue; areas with superficial peripheral arteries

Why should puncture sites be rotated?

To minimize soreness

What should the nurse review before blood glucose testing?

The testing order; the glucometer instructions; equipment condition; quality control status; test strip compatibility and expiration

What should the nurse verify about glucometer quality control?

Quality control tests must be current

What should the nurse check about the glucometer before use?

The equipment should be in good working order

What should the nurse verify about test strips?

They must be compatible with the glucometer and not expired

How can a glucometer be turned on?

Press the power button or insert the test strip

When should client information be programmed into the glucometer?

When applicable according to the device instructions

What should the nurse avoid when handling a test strip?

Do not touch the test area

What should the nurse do with the test strip container after removing a strip?

Recap the container tightly

What should the nurse check after inserting a test strip?

The code displayed on the monitor should match the code on the test strip container

How long does a glucometer take to display a glucose result according to the slides?

The result is displayed within 40 seconds

How accurate are glucometers according to the slides?

They are reasonably accurate; some variability occurs between units

When are glucometers least accurate?

During episodes of hypoglycemia

How should the nurse dispose of a used lancet?

Place the contaminated lancet in a sharps container

What should the nurse do after completing blood glucose testing?

Dispose of supplies properly; remove gloves; perform hand hygiene; turn off and disinfect the glucometer; return equipment; restock the tray; document the result and intervention

What should the nurse do after obtaining a blood glucose result?

Document the result and subsequent intervention

What should the nurse do if sliding scale insulin is ordered?

Administer insulin according to the prescribed sliding scale

What should the nurse do if a blood glucose result is outside institutional parameters?

Follow facility policy for further intervention

What is hyperglycemia according to the slides?

Blood glucose above 106 mg/dL

What are common causes of hyperglycemia?

Type I diabetes mellitus; uncontrolled glucose with oral antidiabetics or diet; infection; surgery; corticosteroid use; uncontrolled gestational diabetes; high-calorie tube feedings or parenteral nutrition; DKA or HHS

How can hyperglycemia be treated long-term according to the slides?

Oral antidiabetic medications

What types of insulin may be used to treat hyperglycemia?

Rapid-acting; short-acting; intermediate-acting; long-acting insulin

What does DKA stand for?

Diabetic ketoacidosis

What does HHS stand for?

Hyperosmolar hyperglycemic state

What is hypoglycemia according to the slides?

Blood glucose below 60 mg/dL

What are common causes of hypoglycemia?

Fasting; excessive exercise or exercise without replacement; dietary changes; hormone deficiencies; excessive diabetes medication

What medication is listed for hypoglycemia treatment by IV push?

D50W

What should follow D50W administration according to the slides?

An infusion of D5W

What is glucagon used for in this PowerPoint?

Treatment of hypoglycemia

What routes are listed for glucagon administration?

Subcutaneous; intramuscular; intravenous

What should the nurse know about glucagon's duration of action?

It has a short period of action

What should follow glucagon administration to prevent recurrent hypoglycemia?

An oral or intravenous carbohydrate

What is the main nursing priority when a blood glucose result is abnormal?

Recognize the abnormal result; follow ordered treatment and facility policy; reassess and document the response

Exam focus:

Based on your exam blueprint, Blood Glucose Testing is listed for 2 questions. Prioritize the normal fasting range, when to test, causes of hyperglycemia versus hypoglycemia, and the treatments listed in your slides.