Meters and CGM Flashcards
What is the purpose of glucometers for patients and providers
- Shows how diet, activity, stress, medications affect blood glucose
- Indicates whether or not good glycemic control is being achieved
- People with DM can modify their diet, weight, and activity to improve glycemic control
• Modify the pre-meal dose based on bg value - Health care providers can use results to modify medication regimen to improve glycemic control
How does a glucometer work
- Blood is applied to glucometer strip
- Glucose reacts with glucose oxidase in the strip
- Chemical rxns = ferrocyanide
- Electrical current is produced
- Current strength is measured by glucometer (current level is directly proportional to glucose level)
- Meter converts current to digital number
- Number is displayed on screen
How accurate must a glucometer be
- results > 75 mg/dL
- results < 75 mg/dL
- > 75 mg/dL: 95% of test results must be within +/- 20% actual blood glucose level
- <75 mg/dL: 95% of test results must be within +/- 15 points of actual blood glucose level
What are the steps in taking blood glucose
- Wash hands with warm, soapy water. Rinse and dry
- Prepare lancet: remove cap, insert lancet, replace cap, adjust depth
- Cock the lancing devise and puncture the finger
- Get a round drop of blood
- Apply to strip
• Do not smear or scrape
• Do not reapply blood
• Do not move strip in meter during a test
• Wait for confirmation window to fill completely
How to dispose of strips and lancets
- strips can usually be thrown in trash
- lancets in a needle-safe container
- follow local regulations
When to check blood glucose
- Fasting blood glucose (prior to first calories of the day)
- Before other meals
- Bedtime
- 2 hours after eating
- If don’t feel well
How to properly store glucometer strips
- Don’t store in hot, cold, damp places. Store at room temperature
- Keep strips out of direct sunlight
- Keep strips dry
- Always store in original container
- Replace container cap as soon as remove a strip
Common problems that affect the results of using glucometer strips
- Applying blood incorrectly
- Not applying enough blood
- Testing when temp is too cold
- Dehydration of patient
- Hematocrit too high or too low
- Liquids got into test port
- Excessive handling that covers strip with dirt, lotion, oils from hands
- Store strip outside of original container
- Leaving the top off of a storage container
- Prolonged exposure to humidity, heat, light
How many times can a syringe for insulin be used?
once, use a new syringe every time inject insulin
What are the first things to check when drawing up insulin in a syringe?
- correct type of insulin (many people have both basal and bolus)
- correct size of syringe
Steps to using the syringe
• Wash hands with soap and water
• Clean rubber stopper on insulin vial with alcohol
• Remove orange cap from syringe
• Pull plunger back until lines up with the number of units want to inject
• Push needle through rubbers stopper and push plunger down. Leave needle in vial
• Turn vial and syringe upside down and hold at eye level, pull the plunger down to the unit line slightly past the dose you want to give.
• Check syringe for air bubbles. Small bubbles are not dangerous, just take up space and keep from getting full dose
- If bubbles are present, push plunger all the way back in, pushing insulin back into the vial. Re-pull the plunger back down. May have to repeat a few times.
• Take needle out of vial and inject
four insulin injection sites on teh body
- abdomen
- thigh
- outer upper arm
- hip area
How is CGM used in the monitoring of a person’s blood glucose?
- Continuous glucose monitoring
- Glucometer gives you a snapshot of glucose, doesn’t tell you about past or future
- CGM measures glucose levels every 5 minutes, sends data wirelessly to computer
• Know if glucose moving up or down and how fast - Proven to lower A1C
• Can easily make DM tx decisions bc have more blood glucose information
