Biochemical and Clinical

Skills Laboratory
KAY MA. PEARL S. REYES RND, MD
Outline

 Biochemical
 Capillary Blood Glucose

 Clinical
 Blood Pressure Monitoring
 Respiratory Rate
 Pulse Rate
 Temperature
 Physical Examination
Biochemical Skill
Laboratory
Capillary Blood Glucose Monitoring

  Plays an important part in achieving levels of diabetes control which are

associated with a reduction in the risk of developing diabetes complications.
 It is vital that the results of CBGM are used to adjust treatment to achieve
the recommended blood glucose targets.
 CBG uses a drop of blood from a finger prick to get a blood glucose reading
using a blood glucose meter, or glucometer
Materials:
Glucose Meter
  referred to as a "glucometer", is a medical device for determining the
approximate concentration of glucose in the blood.
Materials
Glucose Strip
 Consists of an enzyme called Glucose Oxidase.
 Glucose Oxidase reacts with glucose in the blood droplets applied on the test
strips and forms gluconic acid.
 Gluconic acids will react with ferricyanide to form ferrocyanide.
 Glucometer passes electric current onto the test strips.
 The electric current reads the ferrocyanide and determine the blood glucose
level
Materials:
Lancet Needle
 is a pointed piece of surgical steel encased in plastic, used to puncture the
skin on one’s finger (or other body part) to get a blood sample.
Advantages

 Small blood sample

 Range of alternate sites capable of testing

 Short testing time

 Large display on glucometer

 Easy to use
Disadvantages

 Additional cost of buying test strips

 Pain during finger pricks

Clinical Skill Laboratory
Blood Pressure Monitoring

 The heart supplies the organs and tissues of the body with blood. With every beat, it
pumps blood into the large blood vessels of the circulatory system. As the blood moves
around the body, it puts pressure on the walls of the vessels.

 Two values:
• Systolic blood pressure is the pressure when the heart beats – while the heart muscle is
contracting (squeezing) and pumping oxygen-rich blood into the blood vessels.
• Diastolic blood pressure is the pressure on the blood vessels when the heart muscle
relaxes. The diastolic pressure is always lower than the systolic pressure.
Measuring blood pressure with a
Sphygmomanometer
• A cuff that can be inflated with air,
• A pressure meter (manometer) for measuring air pressure in the cuff, and
• A stethoscope for listening to the sound the blood makes as it flows through the
brachial artery (the major artery found in your upper arm).
Auscultatory

 Listening with the stethoscope to the brachial artery at the antecubital area
of the elbow, then the examiner slowly releases the pressure in the cuff.

 When blood just starts to flow in the artery, the turbulent flow creates a
pounding sound.

 The pressure at which sound is first heard is the systolic blood pressure.

 The cuff pressure is further released until no sound can be heard, at the
diastolic arterial pressure.
Pulse Rate

  directly proportional to heart rate as it measures the expansion and contraction of the
arteries in response to the heart rate per minute.
 The normal heart rate at rest in adults is around 60-100 beats per minute.
Respiratory Rate

• Respiration is the process that occurs when oxygen is inhaled into the lungs,
converted into energy via a chemical reaction, and expelled as carbon dioxide
• You can do this by watching the person's chest rise and fall.
• For the most accurate reading, count for the whole 60 seconds. 

If you're concerned that the person might breathe differently if they know you're
measuring their respiration, try pretending that you're taking their pulse,
instead.
Physical Examination

 General survey.
 The assessment of the patient/client begins on the first contact. It includes
apparent state of health, level of consciousness, and signs of distress. The
general height, weight, and build can be noted including skin color, dressing,
grooming, personal hygiene, facial expression, gait, odor, posture, and motor
activity.
Physical Examination

SKIN
Inspect all skin surfaces first or gradually while assessing the systems.
Skin Inspect the skin for color, edema, lesions, scars, and vascularity. Palpate
to notice moisture, temperature, and skin turgor.
Hair and Scalp
On inspection separate the hair to determine the scalp. Wear clean gloves
if lesions and lice are probable. Assess and note the type of hair i.e. long,
coarse, thick, brittle, presence of alopecia.
Physical Examination

 Nails
The condition of the nails reflects the general health, state of nutrition,
occupation, and level of self-care. Nail biting can reveal the person’s
psychological state. Inspect the nail bed for color, cleanliness, length, texture,
angle between the nail and nail bed, and folds around the nail.

 Eyes
Note any abnormal discharges and color of conjunctiva and sclera.
Physical Examination

 Mouth
Use pen light and tongue depressor to assess oral cavity. Lips Inspect lips for color,
texture, hydration, contour, sores and lesions.

 Bucal Mucosa, Gums and Teeth

Inspect the mucosa for color, moisture and sores. Inspect gums for color,
edema, retraction, bleeding and lesions.
Nutrition Focused Physical Exam

Area Appearance Nutrient Deficiency

Hair Sparse, dry, dull, easily Protein, Zinc, EFA
plucked
Skin Scaly, cracked rash, B- vitamins, Vitamin A
lesions
Lips Cracks at the sides, Vitamin B2, B3, B6
swollen
Eyes Cornea, Conjunctiva Iron, B-complex, Vitamin
A
Tongue Glossitis, Magenta color Vitamin B 12 and B2
Thank you for listening