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GLUCOMETER

Purpose:
 Also known as glucose meters
 It is a small, portable machine that's used to measure how much glucose (a type of sugar)
is in the blood (also known as the blood glucose level). 
 These work by analysing a small amount of blood, usually from a fingertip.
 People with diabetes require regular monitoring of their blood glucose to help them
achieve as close to normal blood glucose levels as possible for as much of the time as
possible.
 Patients in the hospital setting are likely to have inconsistent blood glucose levels.

Nursing Responsibility:
 It is usually the responsibility of the nurse to perform blood glucose readings.
 Ensure that you understand the patient’s condition, the reason for the test, and the
possible outcomes of the procedure.
 Prior to performing a blood glucose test, ensure that you have read and understood the
manufacturer’s instructions and your agency’s policy for the blood glucose monitoring
machines used in your clinical setting, as these vary.
 Determine the patient’s understanding of the procedure and the purpose for monitoring
blood glucose level.
 Before you begin, you should also determine if there are any conditions present that
could affect the reading.
 Inspect the area of skin that will be used as the puncture site and ask the patient if they
are in agreement with the site you have identified to use for the skin puncture.

Safety considerations:
1. Perform hand hygiene.
2. Check room for additional precautions.
3. Introduce yourself to patient.
4. Confirm patient ID using two patient identifiers (e.g., name and date of birth).
5. Check allergy band for any allergies.
 6. Complete necessary focused assessments and/or vital signs and document on MAR.
7. Provide patient education as necessary.

Steps on Blood Glucose Monitoring

1. Review the patient’s medical history for diabetes type, medications, and/or anticoagulant
therapy.
2.  Determine if the test requires special timing; for example, before or after meals. Blood
glucose monitoring is usually done prior to meals and the administration of antidiabetic
medications.
3. Gather equipment needed:
 Disposable latex-free gloves
 Alcohol swab
 Lancet or automatic lancing device
 2 x 2 gauze
 Reagent strips
 Blood glucose meter
4.  Determine if blood glucose meter needs to be calibrated.
5. Assess patient’s sites for skin puncture.
6.  Perform hand hygiene.
7. Have patient wash hands with soap and warm water, and position the patient comfortably
in a semi-upright position in bed or upright in a chair. Encourage patient to keep hands
warm.
8. Remove a reagent strip from the container and reseal the container cap. Do not touch the
test pad portion of the reagent strip.
9. Follow the manufacturer’s instructions to prepare the meter for measurement.
10.  Place the unused reagent strip in the glucometer or on a clean, dry surface (e.g., paper
towel) with the test pad facing up. This step is dependent on the
manufacturer’s instructions.
11. Apply non-sterile gloves.
12.  Keep area to be punctured in a dependent position. Do not milk or massage finger site.
13. Select appropriate puncture site and perform skin puncture.
14.  Gently squeeze above the site to produce a large droplet of blood.
15. Transfer the first drop of blood (or second drop if indicated by agency policy or
manufacturer’s instructions) to the reagent strip and apply following the manufacturer’s
instructions.
16. Immediately press the timer on the meter (unless it starts automatically with insertion of
reagent strip).
17. Apply pressure, or ask patient to apply pressure, to the puncture site using a 2 x 2 gauze
pad or clean tissue.
18. Read the results on the unit display.
19. Turn off the meter and dispose of the test strip, 2 x 2 gauze, and lancet
according to agency policy.
20. Remove non-sterile gloves and place them in the appropriate receptacle.
21. Perform hand hygiene.
22. Review test results with the patient.
23. Document results
 Table 9.1 Blood Glucose Readings that Require Follow-up

Concern Action

Blood sugar outside “acceptable range” Repeat capillary test to confirm, and report if
(<2.2 mmol/L or >20 mmol/L) reading remains out of range.

Order a stat blood glucose (venous sample) by

Blood sugar <2.2 mmol/L or >20 mmol/L laboratory staff and initiate hypoglycemia or
hyperglycemia protocol according to agency policy.

Initiate hypoglycemia protocol according to agency

Blood sugar <4 mmol/L
policy.

Preoperative blood sugar <4 mmol/L or

Call physician.
>20 mmol/L

Post-operative blood sugar >13.5 mmol/L

Test urine for ketones. If positive, monitor urine
(acceptable post-operative range = 8-13
ketones every 4 hours.
mmol/L)

Reference: https://opentextbc.ca/clinicalskills/chapter/8-2-glucometer-use/?
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