BLOOD GLUCOSE MONITORING

DEFINITION
Measuring the blood glucose level with the help of a portable glucometer
A blood sugar test is a procedure that measures the amount of sugar or glucose in the blood
that help to diagnose the diabetes.
RISK FOR DIABETES INCREASE ARE:
 45 years or older age
 Overweight
 Have high blood pressure, high triglycerides or low good cholesterol level
 Don’t exercise much
 A history of gestational diabetes
 History of insulin resistance
 History of stroke or hypertension
 Family history of diabetes.
WHY IS TESTING GLUCOSE AT THE BEDSIDE IMPORTANT
1. Routine bedside testing helps to guide treatment decisions maintaining blood glucose
level with an appropriate range.
2. Routine BG testing helps prevent hypoglycaemia (i.e. less than 70 mg/dl) and
hyperglycemia (i.e. more than 140 mg/dl)
3. It is helpful to determine the life theratening conditions and is essential to maintaining
a high quality of life and increasing life expectancy in patients.
Severe hyperglycemia (i.e. BG level more than 240mg/dl can lead to diabetic
ketoacidosis (DKA) and hyperglycaemic hypermolar nonketotic syndrome(HHNS) .
Hypogylcemic can lead to unconsciousness if the brain does not receive sufficient
glucose to function. Severe hypoglycaemic ( i.e. BG level less than 40mg/dl can ead
to seizures , coma and death.
LEVEL OF BLOOD GLUCOSE
Target glucose level for patients
TYPE OF PATIENT TARGET GLUCOSE LEVEL
Perioperative 80-180 mg/dl
Non critical 140-180 mg/dl; 100 - 140 mg/dl for select
patients if significant hypoglycaemia can be
avoided
Critical 140- 180 mg/dl for select patient if
significant hypoglycaemia can be avoided
Enteral/ parentral feeding recipients 140- 180mg/dl using basal bolus insulin
dosing
Normal BG in patients with and without DM
Time People without diabetes
Before breakfast Under 70- 100 mg/dl
Before lunch, dinner and Under 70- 99 mg/dl
snacks
Two hours after eating Under 140 mg/dl
ARTICLES
1. Blood glucose meter.
2. Testing strips/reagent strips.
3. Sterile lancet.
4. Cotton balls.
5. Alcohol swab.
6. Disposable gloves.
PROCEDURE
NURSING ACTION
1 Check physician’s order
2Review manufacture’s instructions for
glucometer use.
3Gather articles at the bedside.
4Explain the procedure to the patient.
5Have the patient wash hands with soap and
water. Use warm water if available.
6Position the patient comfortably in a semi-
fowlers position or upright position.
7 Wash hands. Don disposable gloves
8Remove test strip form the container and
recap container immediately.
9 Turn monitor on and check whether the
code number on strip matches with code
number on the monitor screen.
10 Take the lancet without contaminating it.
Select appropriate puncture site.
11 massage side of finger for adults toward
puncture site and with alcohol swab.
12 Hold lancet perpendicular to skin and
prick site with lancet. Best location for a
finger stick is the 3rd and 4th fingers of the
People with diabetes
80 – 130 mg/dl
80 – 130 mg/dl
Under 180 mg/dl
RATIONALE
Confirms time for checking blood glucose.
Helps in doing procedure accurately.
Provides an organised approach during the
procedure.
Helps to gain patient’s co-operation.
Washing hands reduces transmission of
microorganisms.
Increases blood flow to puncture site.
Prevents spread of microorganisms. Gloves
protect from exposure to blood and body
fluids.
Immediate protects strips from exposure to
light and discoloration.
Matching the code numbers on the strip and
glucometer ensures that machine is calibrated
correctly.
Aseptic technique maintains sterility.
Massage increases blood flow to the area.
Holding lancet in proper position facilitates
proper skin penetration.
non dominant hand
-Avoid the 2nd and 5th fingers if possible
,perform the stick off to side of the centre of
the finger .Never use the tip or centre of the
finger
The middle or ring finger is preferred as
having the greatest depth of tissue beneath
the skin and hence offering the least chances
of injury.
The thumb or index finger may be more
likely to be calloused or scarred, as well as
being much more sensitive, making the
procedure more painful.

13 Wipe away the 1st drop of blood from the
site.
14 Lightly squeeze or milk the puncture site
until a hanging drop of blood has formed.
The first drop may impede accurate result
because it may contain large amount of serous
fluid.
The blood droplet should be large enough to
cover the test pad on the strip and it also
facilitates accurate test results.

15 Gently touch the drop of blood to pad on Smearing of the blood will alter results.
the test strip without smearing it.
16 Insert strip into glucometer according to Correctly inserted strip allows glucometer to
directions for that specific device. Some read blood glucose level accurately.
devices require that the drop of blood is
applied to a test strip that has already been
inserted in the monitor.
17 Apply pressure to puncture site using a This will stop bleeding at the site.
dry cotton ball.
18 Read blood glucose results displayed on
the monitor and inform the patient about
results.
19 Turn off the glucometer.

20 Dispose supplies appropriately and Reduces contaminations by blood. Sharps

discard lancet in sharp’s container. must always be handled properly to protect
others from accidental injury.

SPECIAL CONSIDERATIONS
 check the test/ regent strips for expiration before using
 protect the strips from light, heat and moisture.
  Avoid selecting cold, cyanotic and swollen puncture site to ensure adequate blood
sample.
 When using blood from refrigerated sample allow the blood to return to room
temperature before testing it.
BIBLIOGRAPHY :

 Jacob annamma textbook of clinical nursing procedures the art of nursing practice 2 nd edition
JP brothers medical publisher 2010 edition page number 89 -90
 https://www.diabetes.co.uk/blood-glucose/how-to-test-blood-glucose-levels.html
 https://www.news-medical.net/health/How-to-Test-Blood-Glucose.aspx