NURS121B Glucose check and insulin pen injection

Here is a step-by-step checklist for a blood glucose check and insulin injection:

Blood Glucose Check

1. Patient Positioning and Assessment

   • Place patient's hand in a dependent position to ensure optimal blood flow.

   • Check that the hand is warm.

2. Fingertip Assessment

   • Assess the selected fingertip for intact skin, absence of scarring, bruising, or bleeding.

   • Reassure the patient about the procedure.

3. Site Cleansing

   • Cleanse the selected fingertip site with an antiseptic wipe.

   • Allow the area to air dry completely.

4. Glucometer Setup

   • Turn on the glucometer.

   • Check the test strip for expiration date.

   • Insert the test strip into the glucometer, face up.

   • Wait for the glucometer to blink, indicating readiness.

5. Lancet Preparation

   • Twist and pull off the safety cap of the lancet.

   • Note: For simulations, use mannequins.

6. Blood Sample Collection

   • Align the lancet with the lateral edge of the fingertip pad.

   • Puncture the fingertip.

   • Discard the initial drop of blood (may be contaminated).

   • Collect the second blood drop with the glucometer test strip.

   • Offer gauze to the patient and apply pressure to the puncture site.

7. Blood Glucose Reading Interpretation

   • Read the blood glucose level from the glucometer.

   • Communicate the reading to the patient clearly.

Insulin Administration

1. Medication Administration Record (MAR) Check

   • Double-check the patient's name and date of birth (e.g., Mr. Edema, 10/30/1970).

   • Confirm if the patient has any known allergies.

2. Insulin Prescription Verification

   • Verify the prescribed insulin (e.g., Insulin Regular per medium sliding scale before meals and bedtime).

   • Note current time and blood sugar level (e.g., 08:00, $222$).

3. Dose Calculation

   • Calculate the insulin dose based on the sliding scale (e.g., blood sugar of $222$ translates to $4$ units).

4. Insulin Preparation

   • Disinfect the insulin vial with an alcohol wipe.

   • Check the needle expiration date.

   • Assemble the syringe: remove one cap and hold upright.

   • Draw $4$ units of insulin into the syringe.

5. Collaborative Verification

   • Engage another nurse (e.g., Nurse Kim) for a second verification of the administration details (patient name, DOB, allergies, medication specifics, and dose).

6. Patient Education (Pre-Injection)

   • Inform the patient that insulin will help lower blood glucose levels.

   • Educate them on potential hypoglycemia symptoms: trembling, anxiety, sweating.

   • Urge the patient to eat when breakfast arrives to prevent hypoglycemia.

7. Injection Site Preparation

   • Assess previous injection sites for bruising, bleeding, or scarring.

   • Select and cleanse a new injection area, allowing it to air dry.

   • For thinner patients, gently pinch the injection area.

   • Inform the patient they may feel a slight poke.

8. Insulin Injection

   • Execute the injection with a swift motion until a click is heard or felt.

   • Pause for $10$ seconds after injection to allow for full absorption.

9. Post-Injection Care

   • Inspect the injection site for any leakage; cover with gauze if needed.

   • Safely dispose of the used sharps into a sharps container.

   • Dispose of other materials into waste receptacles.

   • Clean the injection pen with alcohol.

   • Perform proper hand hygiene and ensure gloves are worn.

10. Conclusion of Procedure

    • Confirm with the patient if they have any questions regarding the procedure or their current status.

    • Ensure all equipment and materials have been appropriately managed and disposed of.