Finger-stick Blood Glucose Level: Introduction (Nursing)

00:04 Welcome to the series, finger-stick blood glucose level.

00:07 This is also commonly known as a blood sugar, you may hear that name often.

00:12 So we're typically going to get this important piece of diagnostic information in several different patient conditions but especially our diabetic patients.

00:22 So let us look at some important points to keep in mind.

00:26 Now, the principles of obtaining the actual level is about the same throughout.

00:31 But just know there are several different types of glucose monitors and there's a lot of variations to this.

00:38 So you want to become really familiar with the agency equipment that you have.

00:42 Just know also that the equipment used in a hospital versus the stuff that maybe your patient uses at home is going to be quite a bit different, and therefore the capabilities and the limitations of your monitor will vary.

00:58 Just keep in mind when we're talking about obtaining this, now the client's order is going to vary quite a bit.

01:05 It's going to be relevant to their condition.

01:07 Here is a great example of that.

01:09 If we're talking about a diabetic patient, for example, we may obtain this level maybe AC and HS, otherwise know as before meals and at bedtime.

01:20 You may also see the order for blood glucose level every 6 hours.

01:24 This could be potentially because your patient is on ongoing to feeding on nutritional supplements.

01:31 Now, some higher level care like the intensive care unit, we may take this level a lot more often.

01:38 So when we're talking about a blood glucose level, it's important to know really critical ranges.

01:45 What I'm talking about here is your facility's protocol for what we say is hypo, meaning low and hyper, meaning high glycemia.

01:54 So a high and low blood sugar.

01:56 So hypoglycemia, most facilities are going to say that this is the case when your patient's blood glucose reaches less than 70 mg/dL.

02:08 We also define hyperglycemia, most commonly, greater than 140 mg/dL.

02:15 Now let's note that the American Diabetes Association is going to define hypoglycemia as less than 54 mg/dL.

02:26 They're also going to define severe hypoglycemia of less than 54 mg/dL with symptoms.

02:37 Now let's talk about some signs and symptoms of both of those conditions.

02:41 So when we're talking about hyperglycemia, meaning an elevated blood glucose, defined as greater than 140 mg/dL, here are some signs and symptoms that you may see: such as fatigue, maybe blurred vision, maybe excessive thirst or fruity breath.

03:00 So let's just talk about the fruity breath, that's typically meaning that we have blood glucose in the extremely elevated ranges.

03:08 And this could mean the patient's blood glucose is so high, they could be close to going into a coma.

03:15 This is an emergency.

03:17 Now, some clients may not display symptoms of hyperglycemia until the blood glucose is extremely high.

03:24 Or the patient could also have nausea and vomiting and increased urination.

03:29 So just know with typical hyperglycemia, if this is a chronic issue for our diabetic patients.

03:36 Now, the patient could be running at maybe 200's (mg/dL), for example for a long time and not have many of this symptoms or even any at all.

03:45 So this is why important glucose monitoring is a great education for your patients who have diabetes.

03:53 Now let's look at the flip side of that otherwise known as hypoglycemia.

03:58 Now, depending on your agency's protocol, it could be defined as less than 70 (mg/dL) or here, as less than 54 mg/dL.

04:08 Now here's the difference.

04:10 When a patient has hypoglycemia, they are much more likely to show symptoms here.

04:16 Such as anxiety, just not feeling right, a lot of confusion, some tingling.

04:22 The patient may start having diaphoresis or sweating and getting clammy, tachycardia or fast heart rate, hunger or even the shakes or tremors.

04:31 So when you're talking about hypoglycemia, this is typically much scarier for you as a nurse and has to be treated quickly.