CAPILLARY BLOOD

GLUCOSE MONITORING,
BLOOD TRANSFUSION
URSULA COMLA P. FILIO, R.N.
CAPILLARY BLOOD GLUCOSE
MONITORING

• Measures the level of glucose in your blood

• Involves a finger prick
• Used to screen for Type 2 Diabetes, diabetes control and reduce the
risk of developing diabetes complications
• Results are used to adjust treatment to achieve the recommended
blood glucose targets. 
EQUIPMENT AND SUPPLIES

 Disposable Gloves
 Sterile Lancet
 Lancet Injector
 Antiseptic Swab
 2 x 2 Gauze
 Blood Glucose Meter (Glucometer)
 Blood Glucose Reagent Strip (compatible with the meter)
 Sharps Container
 Hazardous Waste Bin
ASSESSMENT

• The client’s skin at the puncture site to determine if it is intact and the
circulation is not compromised.
• The client’s record for medications that might prolong bleeding, such
as anticoagulants.
• The client’s self-care abilities that might affect the accuracy of test
results, such as visual impairment and finger dexterity.
PROCEDURE

• Refer to medical record.

• Assemble supplies.
• Introduce self.
• Identify patient
• Explain procedure to patient.
• Perform hand hygiene.
• Select site on any fingertip. Wipe selected site with alcohol swab and
discard swab.
PROCEDURE

• Don gloves.
• Remove cap from lancet using sterile technique.
• Place lancet into automatic lancing device.
• Gently squeeze fingertip.
• Hold lancing device. Place trigger platform of lancing device on side
of finger and press.
• Squeeze finger and wipe off first drop of blood that appears and
continue squeezing.
PROCEDURE

• While holding reagent strip level, touch new drop of blood on finger
to test pad. Do not allow finger’s skin to touch the test pad.
• Begin recommended timing and wait for numeric readout.
• Ask the client to apply pressure to the skin puncture site with a 2 x 2.
PROCEDURE

• Turn off the meter and discard the test strip and 2 x 2 gauze in a
biohazard container. Remove lancet from device and discard into
sharps container.
• Remove gloves, discard accordingly and wash hands.
• Document procedure and results.
BLOOD TRANSFUSION

• A medical procedure in which donated blood is provided to you

through a narrow tube placed within a vein in your arm
• Help replace blood lost due to surgery, injury, disease or bleeding
disorders
RISKS

•Allergic reactions, which might cause hives and itching, and fever
•Bloodborne infections (HIV, Hep. B or C)
•Other reactions:
•Acute Immune Hemolytic Reaction - donor blood type is not a good
match; harms your kidneys.
•Delayed Hemolytic Reaction - occurs more slowly (one to four weeks);
decrease in red blood cell levels
•Graft-Versus-Host Disease - transfused white blood cells attack your
bone marrow; affect people with severely weakened immune systems
EQUIPMENT AND SUPPLY

Alcohol Swabs
10 cc Syringe
Clean Gloves
Blood Product
Blood Administration Set
500 ml Normal Saline for Infusion
IV Pole
Venipuncture Set Containing a #18
or #19 Gauge Needle or Catheter
Tape
PREPARATION

• Perform hand hygiene.

• Provide patient privacy.
• Introduce yourself.
• Use two patient identifiers.
• Verify physician’s order.
• Ensure that an informed consent has been signed.
• Verify allergy status.
PREPARATION

• Provide patient education. Explain the procedure, educate patient

about the rationale of the procedure, and associated adverse reaction
(any sudden chills, nausea, itching, rash, dyspnea, back pain, or other
unusual symptoms).
• Ensure patency of IV line. If the client has an intravenous solution
infusing, check whether the needle and solution are appropriate to
administer blood.
• Take and record baseline vital signs.
PREPARATION

• Assemble supplies before entering patient’s room.

• Complete pre-transfusion steps prior to blood transfusion infusion.
• Two nurses must verify blood and request form before the start of the
procedure. (Name, identification number, blood type and Rh group,
the blood donor number, and the expiration date of the blood. Observe
the blood for abnormal color, RBC clumping, gas bubbles, and
extraneous material. Return outdated or abnormal blood to the blood
bank)
PREPARATION

• Sign the appropriate form with the other nurse, according to agency
policy.
• Make sure that the blood is left at room temperature for no more than
30 minutes before starting the transfusion.
PROCEDURE

• Don gloves.
• Verify the client’s identity.
• Check patency of IV line.
• Hang normal saline flush bag.
• Spike normal saline bag and prime tubing. Make sure to fill blood
tubing filter completely.
• Spike blood bag. Open blood roller bag and prime tubing. Be sure to
prime the entire line.
PROCEDURE

• Connect IV tubing to patient’s IV access. Set infusion to run slowly at

20 gtts/min for 15 minutes.
• Monitor patient for adverse reactions (chilling, nausea, vomiting, skin
rash, or tachycardia). Measure vital signs after 15 minutes to ensure
patient is tolerating blood transfusion.
• Establish the required infusion rate per physician’s order. Do not
transfuse a unit of blood for longer than 4 hours.
• Measure vital signs every 30 minutes for an hour when infusion is
complete.
POST-PROCEDURE

• Disconnect blood tubing.

• Flush IV line.
• Discard tubing and blood bag.
• Perform after care.
• Perform hand washing.
POST-PROCEDURE

• Document relevant data. On the requisition attached to the blood unit,

fill in the time the transfusion was completed and the amount
transfused.
• Note patient’s response to transfusion. Record completion of the
transfusion, the amount of blood absorbed, the blood unit number.
Also record the transfusion on the IV flow sheet, and intake and
output record.