Now, let's take a look at how
we obtain that blood glucose.
So first of all is our portable glucose monitor.
And again, this is going to vary
depending on if you're in a hospital
or at home or the monitor that the patient's using.
We're also going to need our
blood glucose test strips.
So this is important because not any
test strip can be used on any monitor.
You have to make sure these are compatible.
And next is the lancet which is what's going to
give the puncture to obtain the blood glucose.
And again, the lancets can vary
slightly from facility to facility.
You're going to need an alcohol pad for cleaning
and some sort of gauze pad or even a cotton ball.
So let's talk about how we obtain that blood glucose.
Before we get started, we're
going to perform our hand hygiene,
provide privacy and explain
the procedure to the patient.
You want to raise that bed to
an appropriate working height
and then position the client with
their hand in the dependent position.
We want to go ahead and perform our hand
hygiene again and now put on our gloves.
So this is the time to identify our puncture site.
Many times, this is going to be in
the patient's finger, for example.
Now here's an important note.
We typically don't go in the
middle of the pad of the finger.
We typically kind of go around the outer edges.
Now occassionally, we may need to dilate those
capillaries and put maybe a warm washcloth
or some sort of compress on there to help dilate
those capillaries so we can get a good result.
Now, what we don't want to do
and you may see in practice
is a squeeze really hard when we're
talking about identifying a puncture site.
That's not ideal because we
can skew the results this way.
So at all possible, try to avoid
squeezing the finger tightly.
Now we can go ahead and turn on that blood
glucose on and select the client test.
Then, we're going to input the
client's information into the meter.
Now typically, we can do this
expecially if we're in a hospital
by taking the glucose monitor and
scanning the patient's bracelet.
Then we're going to input the information
from our test strips in the glucose monitor.
So again, this is typically by taking
our monitor in scanning the test strips.
Now once your monitor has identified the strips,
we can insert the strip into the monitor itself
then we can clean the side of the
patient's finger with the alcohol pad
and allow it to completely air dry.
Do your best not to try to wave or blow on
it here, just allow it to completely air dry.
Then we can use our lancet to
puncture the identified site.
Now here's a thing that many
times students forget to do.
Make sure you wipe away that first drop of
blood using the gauze pad or cotton ball.
This could be a contaminated sample and
not the one we want to use for test.
Now, we touch the test strip to that drop of blood.
We've got to make sure the test
strip area is completely filled.
Now once that occurs, usually your meter
is going to start running its results.
We can apply pressure to the puncture site
while the results are being processed.
Now, we're going to read the digital
display when processing is complete.
Let's take a live look on how we obtain
a blood glucose sample from a patient.
So I'm going to go ahead and do this on
myself today and just talk you through this
and I've got my supplies here ready.
So the first thing after we perform our hand
hygiene, we've explained this to the patient,
we want to make sure also we have the right
patient by using our patient identifiers,
the patient's name and date of birth.
Then we want to go ahead and
identify our puncture site
and many times, it's going
to be your patient's fingers.
So today I'm just going to use this finger here.
Here's the other piece of this
is when we do a puncture site,
we're going to do our patient's
fingers but not the middle pad here.
We're typically going to get maybe the
soft, cushy side portion of their finger.
Also note, if your patient's diabetic and have been
poked a lot, you can see those little pin pricks,
rotate sites as much as possible.
So once we've identified
our puncture site here,
what we don't want to do is stay here
and squeeze on our patient's finger.
If we need to dilate those capillaries, we
can put a warm compress on there if needed.
Now, we have a home meter that
I'm going to use to demonstrate
but I'm also going to talk you through
the steps if we were using equipment
that's widely used in acute care
or the hospital for example.
So I'm going to go ahead and
turn on my blood glucose meter.
Now if I was using one in the hospital, we've
got to make sure we've got the right patient.
So on the display screen, you
would see an option for a client test.
So you'd make sure you would choose that option.
Then after we did that, we have to make
sure we input the client's information.
And again, if I was at home,
this wouldn't be a problem
but if we're using this in acute care
facility,we want to input the patient's data
and typically this is going to be by tagging
the meter and scanning the patient's bracelet.
So that's going to make sure to
upload the patient but of course,
make sure that you as a provider
or the healthcare personnel,
verify the two patient identifiers:
the name and the date of birth.
Now once we've made sure we have the right patient,
we've got to identify the strips to the meter.
So we're going to input that information as well.
It would be by the same method that we would
take our meter and we would scan our strips,
the barcode here.
We've got to make sure these test
strips are recognized by our meter.
Now once we've done this, we
can go ahead and insert the strip.
So once we insert our strip,
usually it's got the piece here
where there's a little-bity grey box,
that's what's going to fill up with blood.
That's the piece that should point outwards,
the other piece it's what's going to slide
in our meter itself.
Now when you slide the glucose strip in, it doesn't
matter which type of meter you're going to use,
it will recognize that there's
a strip and it's ready to go.
You also know it's ready by seeing this little
drop of blood and that's common on most meters.
So now that I've got my test strip ready, now I can
go ahead and clean the site with an alcohol pad.
Now of course I'm doing this on
myself but if I was in the hospital,
I would be donning my gloves.
So for this demonstration, I'm
just going to do it on my own finger.
So now I'm going to go ahead and take my alcohol pad,
take the puncture site that I identified and
I'm going to make sure I clean this thoroughly.
It's also important to allow
this to completely air dry.
Now just now, each facility uses a little
bit of a different lancet so just know that.
So this one, I'm going to take this out.
Make sure you get familiar with your lancet because
again, each one of these is a tad bit different.
So I just pulled off the stopper here,
then I'm going to take my lancet,
I'm going to push it towards the
pad and keep little pressure here.
And then I'm going to push down the top, you're
going to hear a click and puncture the site.
So once you've seen this, you see that I've
got a drop of blood here which is great.
So and we don't want to squeeze too hard.
I'm just going to squeeze lightly and make
sure I wipe the first drop of blood off.
Now this is, you can imagine, may
have some of the alcohol from it,
from where we cleaned, and dirt and debris.
So we want to make sure we
take off that first drop of blood.
Now, it's not a bad idea to make sure
you have an ample amount of blood.
It's okay to lightly, as you see,
compress the finger not squeeze
to get enough sample to fill our test strip.
So here's the piece about the test strip, we don't
want to lay this on top of the drop of blood.
We want to take this to the blood and
make sure that it fills up the test strip.
Now once we've done that, we will get our
meter to read, it'll start reading for you.
Then after we've done that, we can go ahead
and apply pressure to the puncture site
as the results are being processed.
Now once that's done, we can read the digital
display and then when the process is complete.
And then just if you were at home, you may
end up loading that to a certain device
so we'll put it into the patient's chart.
Now once we've completed this, we
can remove the test strip from the monitor.
Discard the lancets and the sharps and
supplies in the proper waste basket.
Remove our gloves, perform hand hygiene
and of course document the procedure.
But once we've gotten this, we can
remove our test strip from our meter,
we can dispose of this, discard
the lancet in the sharps box,
our supplies into the proper waste basket,
Remove our gloves, perform our hand hygiene
and of course document the procedure.
Now here's a really important
point to note before we go.
It's important to know your
facility's normal glucose ranges.
If it's out of range, this may
warrant that you contact the nurse
or if you're the nurse themselves,
you may need to look for these results
to see if they need prompt attention.
Thanks for watching today.
Let's visit some special considerations when
we're talking about obtaining a blood glucose.
So there's something we call control tests.
Now these need to be completed at least every
24 hours for your meter to work properly.
Also, anytime that you open up a test strip bottle,
we need to make sure we place our initial
when we opened it and the date of expiration
because these test strips can expire.
Also, if we end up opening up any control vials as
well to run our test, we need to date those as well.
Just note that test strips usually expire
between about 6 month from opening
and those control vials will expire
about 3 months from opening.
We of course want to make sure we
are not using expired equipment
because this can skew our results.
Now if you're talking about
using a blood glucose meter,
especially when we're talking
about the acute care facilities,
you're typically going to have to
use this meter on multiple patients.
So it's important that we clean this between use.
Now some patients that require a blood
glucose may be in isolation precautions.
So follow your facility's policy on how you are
to do that to make sure we don't spread infection.
So this could be that we place
the meter, in a bag for example,
while we take it in that patient's
room and disinfect properly.
Now, supplies can be stored in a
common area and used for all clients,
kind of like we talked about for the meter.
However, once you enter into a patient's
room, please only bring the supplies necessary
for that particular client.
Because once we bring strips
or extra lancets in the room,
it can only be used for that client and
we don't want to waste extra supplies.
Thanks for watching today.