Skill 9
Blood Glucose Testing
Blood glucose monitoring allows patients with diabetes mellitus to self-manage their disease. Obtaining capillary blood by skin puncture is less painful than venipuncture, and the ease of the skin puncture method makes it possible for patients to perform this procedure. Glucose levels can be evaluated by performing a skin puncture and using either a visually read test (e.g., Chemstrip bG, Glucostix) or a reflectance meter. Measurement by a visually read test may not be accurate but can be useful for screening. Blood glucose reflectance meters are lightweight and run on batteries (e.g., Accu-Chek III, OneTouch) (Fig. 9-1). After a drop of blood from the skin puncture is dropped or wicked onto a reagent strip, the meter provides an accurate measurement of blood glucose level in 5 to 50 seconds. The various methods allow measurement of blood glucose between 20 and 800 mg/dL, thus providing a sensitive measurement of blood glucose level.
Delegation Considerations
Assessment of a patient’s condition cannot be delegated to nursing assistive personnel (NAP). When the patient’s condition is stable, the skill of obtaining and testing a sample of blood for blood glucose level can be delegated to NAP. The nurse informs the NAP by:
▪ Explaining appropriate sites to use for puncture and when to obtain glucose levels.
▪ Reviewing expected blood glucose levels and when to report unexpected glucose levels to the nurse.
