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NURS 2532 > Lab 3 - BG Monitoring > Flashcards

Lab 3 - BG Monitoring Flashcards

1
Q

why is self-monitoring of BG important?

A
  • allows the pt to make self-management decisions regarding diet, exercise, and meds
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2
Q

what is the chief advantage of SMBG

A

supplies immediate info about BG that can be used to make adjustments to;
- food intake
- activity patterns
- med dosages
also:
- alerts the pt to acute episodes of hypo/hyperglycemia
- provides the patient w a tool for achieving specific glycemic goals
- produces accurate records of glucose trends

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3
Q

what determines the frequency of BG monitoring?

A
  • the glycemic goals
  • type of diabetes
  • ability & willingness to perform the test independently
  • the treatment regimen
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4
Q

how often is it recommended for type 1 DM patients to test ther BG

A
  • 3 times/day
  • includes both preprandial and postprandial
  • if they have an insulin pump = more often
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5
Q

how often should patients w type 2 DM monitor their BG

A
  • at least once daily
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6
Q

what should be done if you suspect hypoglycemia?

A
  • test the BG
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7
Q

what do you do if the pt with diabetes is ill

A
  • test BG every 2-4 hrs to determine the stressor effects on BG
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8
Q

what are the 2 methods for self-testing of BG

A

both require obtaining a large drop of blood by skin puncture & applying the blood to a testing strip

  1. compares the strip to a color chart
  2. uses reflectance meters
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9
Q

what are examples of strips that use the first method of BG testing

A
  • chemostrip bG
  • glucostix
  • trendstrip
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10
Q

what is a con to the first method of BG testing

A
  • can be inaccurate
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11
Q

what are some examples of reflectance meters for BG testing

A
  • glucometer II
  • accu-check II
  • glucoscan
  • onetouch
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12
Q

what are 3 pros to the use of reflectance meters

A
  • accurate
  • fast: gets the results within 5-50 sec
  • some meters can be programmed to monitor glucose levels for a continuous 72 hrs
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13
Q

what are 2 types of testing used for reflectance meters? do all meters require this?

A
  1. wet-wash
  2. dry-wipe

some do not require this

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14
Q

what is the wet wash method of testing

A
  • the user flushes the blood coated testing strip with water before inserting it into the glucose meter
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15
Q

what is the dry-wipe method of testing

A
  • the user wipes off the blood-coated testing strip with a dry cotton ball before the reading
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16
Q

what are 3 commonly used sites for puncture for BG monitoring? what are 3 alternative sites?

A

common:

  • finger
  • toe
  • heel
    alternative:
  • forearm
  • palm
  • thigh
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17
Q

describe the steps for BG monitoring pre-puncture; include risks, what to assess, etc. (6)

A
  • assess the pt’s understanding of the procedure & purpose
  • determine if specific conditions need to be met before or after (ex. after meals, with fasting, etc.)
  • determine risks for performing skin ouncture (ex. low plt, anticoagulant therapy, bleeding disorders)
  • assess puncture site
  • review orders, times, & frequency
  • explain procedure & purpose
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18
Q

what do you want to avoid when choosing a site for glucose puncture

A
  • bruises

- open lesions

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19
Q

describe the steps for BG puncture

A
  • hand hygeine
  • get pt to wash hands
  • position pt comfortably
  • remove test strip
  • turn on monitor & insert strip
  • remove unused glucose test strip from meter & place on clean surface
  • apply gloves
  • choose puncture site & clean with alcohol wipe
  • unconver lancet,hold perpendicular to site & pierce skin
  • wipe away first drop of blood with cotton ball
  • squeeze puncture site to get a good size of blood
  • hold strip up to top of blood drop & place in meter for results
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20
Q

why dont we take the first drop of blood after puncture?

A
  • it will contain more seroud fluid than blood
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21
Q

diabetic patients typically have peripheral vascular disease which makes it difficult to produce a large drop of blood. how can we improve blood flow?

A
  • hold the pt’s finger in a dependent position before puncturing
22
Q

describe the steps for monitoring post-puncture (6)

A
  • turn meter off
  • dispose of garbage
  • discuss test results w patient
  • reinspect puncture site for bleeding or tissue injury
  • compare glucose monitor reading w normal BG levels
  • ask patient to discuss procedures & explain test and results
23
Q

what is a lancet

A
  • the small, sharp object used to prick the skin in BG monitoring
24
Q

what are 2 common puncture sites in infants

A
  • heel & great toe
25
what is a common puncture site for older pediatric patients
- the earlobe
26
what is considered normal range for FBG
4-7 mmol/L
27
what is hypoglycemia
- low BG = <4 mmol/L
28
what 2 systems do signs of hypoglycemia occur in?
- SNS stimulation = below 3.5 | - CNS depression= below 2.5
29
list some SNS signs of hypoglycemia
- tachycardia - palpation - anxiety - shaking, trembling - sweating - hunger - nausea
30
list some CNS signs of hypoglycemia
- confusion - difficulty concentrating - weakness - drowsiness - convulsions - coma - cold, clammy skin
31
what are some of the nurses immediate reactions to a low BG? when should you retest
give some sort of sugar - juice - glucose tabs - glucagon IV or dextrose (if severe) retest in 10-15 min
32
what is hyperglycemia
- high BG >11 mmol/L
33
what are some signs of hyperglycemia
- glucosuria - polyuria & nocturia - polydipsia - polyphagia - blurred vision - abdominal cramps - NV - fatigue
34
what is hypoglycemic protocol
- the steps you follow when someone has a low BG | - the steps vary on the severity of the hypoglycemia
35
what is a hematoma
- pool of clotted or partially clotted blood in an organ, tissue or body space - usually caused by a broken blood vessel
36
what are the categores of insulin
- rapid acting - short acting - intermediate acting - long acting
37
what is the prototype of rapid acting
- lispro | - aspart
38
what is the onset, duration, and peak of rapid acting
onset: 10-15 peak: 30-90 duration = very short but intense
39
what is the prototype of short acting
- humulin R
40
what is the onset, peak, and duration of short acting
- onset: 30 - peak: 2-3 hr - duration = shorter ( but not as short as rapid)
41
what is the prototype of intermediate acting
- isophane suspension | - NPH
42
what is the onset, peak, and duration of intermediate acting insulin
onset = 1-3 hr - peak = 4-8 hr - duration = up to 12 hr
43
what is the prototype of long acting insulin
- glargine | - detemir
44
what is the onset, peak, and duration of long acting
- onset = 1-3 hr - peak = non - duration = up to 24 hrs
45
what type of insulin cannot be mixed?
- long acting
46
when mixing two types of insulins into 1 syringe (rapid/short acting & NPH), which is drawn first
1. put air into cloudy, then air into clear | 2. draw out of clear, draw out of cloudy
47
describe the procedure for mixing 2 kinds of insulin in 1 syringe
- complete all the necessary MAR & med checks - hand hygeine - roll cloudy insulin in hands - wipe tops both vials with alcohol wipe - air into cloudy, then air into clear - without removing the syringe after injecting the air, withdraw fluid from clear - remove any bubbles & ensure correct dose - place needle into the cloudy (or longer acting insulin) & withdraw required med amt for this one - remove needle, cap, and dispose of garbage - hand hygeine
48
how soon should you administer mixed insulin after preparing it? why?
- within 5 min | - bc rapid or short acting insulin binds with the NPH which will reduce the action of the long acting
49
only which type of insulin can be administered IV?
- regular (short acting)
50
what is an insulin sliding scale
- a tool that dictates a certain dose of insulin based of the pt's BG level
51
what type of insulin is typically ordered for sliding scales
- rapid or short acting
52
define induration
- localized hardening of soft tissue of the body | - the area becomes hard but not as hard as bone

NURS 2532 (5 decks)

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