BLOOD GLUCOSE MONITORING

⚫ Capillary blood glucose (CBG) is

taking a blood sample from the
finger using a special needle and
placing a drop of blood on a testing
device called the glucose meter.
(Glucometer)
 Indications:
Detect and monitor blood sugar
level for patient with:
1. Diabetes
2. Enteral and Parenteral feeding
3. Seizures
4. Liver disease
5. Pancreatitis
6. Head injury
• Stroke
• Alcohol/Drug intoxication
1. Neonatal hypoglycemia
Assessment
⚫ Assess the patient history.

⚫ Assess the patient knowledge about

monitoring blood glucose.

⚫ Assess the area of the skin to

be used for testing.

⚫ Avoid bruises and areas with open wound.

Possible Nursing
Diagnosis
⚫Risk for injury
⚫Deficient knowledge
⚫Anxiety
Planning:
1. Blood glucose level is
measured accurately.

2. Patient remains free of injury.

3. Patient demonstrates a blood

glucose level within
acceptable parameters.
4. The patient demonstrates
ability to participate in
monitoring.
5. Patient verbalizes increase
comfort with the procedure.
 EQUIPMENT
⚫ Reagents strips
⚫ portable blood glucose meter
⚫ alcohol pads
⚫ gauze pads
⚫ disposable lancets or
mechanical blood letting devices
⚫ cotton
Sites of collection
⚫ earlobe
⚫ fingertips
⚫ heel
Special Considerations:
⚫ Do not squeeze the puncture site to avoid
diluting the sample with tissue fluid.
⚫ Touch a drop of blood to the reagent patch
on the strip; make sure you cover the entire
patch.
⚫ √Expiration
⚫ √Stability
⚫ √Calibration
⚫ Avoid cyanotic and cold site
Implementation
1. Check the patient’s medical record.

2. Gather equipment

3. Close curtain around bed and

door.

4. Identify the patient. Explain the procedure.

5. Perform hand hygiene. Put on non sterile
gloves.

6. Turn the monitor on.

7. Prepare lancet using aseptic

technique.
8. Remove test strips from the vial. Recap
container immediately. Check the code
of the strip. Some strips comes in
individual wrap.

9. For adult, massage side of finger toward

puncture site.
10. Have patient wash hand. Wipe it with
alcohol. Allow to dry.

11. Hold lancet perpendicular to skin and

pierce with lancet.

12. Wipe away first drop of blood with gauze

or cotton ball if recommended by
manufacturer of monitor.
13. Encourage bleeding by lowering hand
making use of gravity.

14. Gently touch drop of blood to pad on test

strip without smearing it

15. Press time button if directed by

manufacturer
16. Apply pressure to puncture site with a
cotton ball. Do not use alcohol wipe.

17. Read blood glucose result and

document appropriately at bedside.
Inform patient of test result.
18. Turn meter off, remove test strip and
dispose of supplies appropriately .Place
lancet in sharps container.

19. Remove gloves and perform hand hygiene.

PATIENTS TEACHING
If the patient will be using the reagent
strip system at home, teach him proper
use of the lancet or auto lancet, reagent
strips and color chart and portable blood
glucose meter, as necessary. Also provide
the written guidelines.
DOCUMENTATION

Record the reading from the reagent strip

(using a portable blood glucose meter or a
color chart) in your notes or in a special
flowchart, if available. Also record the date
and time of the test.
Glycosylated hemoglobin (HbA1c)
⚫ Provides an index of the patient’s average
blood glucose level over a 2-3 months
period.
⚫ A blood test that give the most accurate
picture of the patient diabetes control.
⚫ Useful in determining compliance with the
therapy and diabetic control.
 HbA1c
⚫ Glycosylated hemoglobin means
that the glucose(sugar) has
attached to the hemoglobin
protein. The higher your blood
sugar is, the more that glucose
get attached to your
hemoglobin.
 HbA1c Interpretation
⚫ 6% - 120 mg/dl (pretty good)
⚫ 8% - 160mg/dl (not bad)
⚫ 10% - 240mg/dl (not good)
⚫ 13% - 330mg/dl (dangerous)
HbA1c is high

⚫ The physician will change the medicine.

⚫ Increase level of physical activity of the

patient.

⚫ Modification of the diet of patient.

 Test for Glucose in Urine
A. Benedicts Test
- Collect urine specimen
before meals.
- Put 5 ml of Benedicts
solution into the
test tube.
- Heat the Benedicts
solution.
- Add 8-10 drops of
urine.
- Heat the Benedicts
solution with urine.
(Do not Boil)
Interpretation of results Benedict’s Test
Blue Negative 100mg/dl

Cloudy Green + 250mg/dl

Yellow Orange ++ 500mg/dl

Orange red +++ 750mg/dl

Brick Red ++++ 2Grams/dl

The End