1. Door County Memorial Hospital
Blood Glucose Monitor
Nursing Staff Education
1

2. Tips to Improving Accuracy When Using
the Blood Glucose Monitor
1. Because the strips are very sensitive to humidity:
- When the test strip is removed from the vial, be sure to put the
cap back on tightly.
- The strip Must be used within 3 minutes of removing it from the vial.
2. Be sure the finger is well cleaned and dry.
3. If insufficient blood is obtained, remove the strip and do the test over.
4. Avoid squeezing around the finger prick area; squeeze the finger from
the base.
5. Wipe off the first drop of blood, but don’t squeeze around the finger
prick to get that second drop. Again, squeeze from the base if you
need more blood.
2

3. Tips to Improving Accuracy When Using
the Blood Glucose Monitor
• Control Solutions expire, three months after opening.
• Test strips expire by the manufacturer’s expiration date on the side of the
vial.
• Quality Control test should be performed every 24 hours.
• If the screen freezes place a paper clip in the slot on the right side of the
meter’s battery cover to reset the meter
• If the Reading result says “Lo”
– The patient’s result is less than 10 mg/dl, repeat test and call for Stat lab
glucose to verify result.
• If the reading result says “HI”
– The patient’s result is greater than 600mg/dl, repeat the test and call for Stat
lab glucose to verify result
• Call for Lab for Stat Glucose if a reading is
– <50 mg/dl or >400 mg/dl
3

4. How To Handle A Meter In An Isolation
Room
• Put the Meter in a clear plastic bag.
• Turn it on and go through the steps up to, and including the
point where you put the strip in.
• Take the meter (in the bag) and a lancet device into the
patients room
• Perform the test
• Discard the plastic
• Clean the meter after every use with a sani cloth wipe. If
suspected isolation room with noro-virus or c-diff disinfect
the meter by cleaning with a bleach wipe.
4

5. How To Perform
A Patient Test
• Turn the meter on and enter operator ID (employee
number)
– NEVER, let another employee log in using your ID
– Instruct co-worker to contact lab/education department if unable to
log into meter.
• Select Patient Test
• Enter Patient ID ( last 7 digits of their account number)
• Verify strip code
• Insert test strip
• Apply Sample
• View Test Result
• Add Comment (s)
5

6. How To Perform
A Control Test
• Turn the meter on and enter operator ID
• Select Control Test
• Select level
• Verify control lot
• Verify strip code
• Insert test strip
• Apply Control Solution
• View result
• Add Comment
6

7. How To Review Result
• Enter operator ID
• Select Review Result
• View “All,” “QC,” or by “Patient”
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8. DOOR COUNTY MEMORIAL HOSPITAL
STURGEON BAY, WISCONSIN
NURSING STANDARD OF CARE (NSOC) - TREATMENT
OF HYPOGLYCEMIA
PURPOSE: To promote safe care of and improve the
nursing management of patients with
hypoglycemia.
Assessment
– All patients with known Type 1 or Type 2 diabetes or gestational diabetes
should be watched for symptoms of hypoglycemia, including shakiness,
sweating, nervousness, hunger, irritability or heart palpitations.
– Infants of diabetic mothers should be similarly assessed.
– If hypoglycemia is suspected, a glucose level should be immediately
obtained by Accucheck.
• Guidelines
– A patient with Type 1 or Type 2 diabetes is hypoglycemic if he has a blood
glucose level under 70 mg/dl.
– A patient with gestational diabetes is hypoglycemic if she has a blood
glucose level under 60 mg/dl.
– A nursery infant of a diabetic mother is hypoglycemic if the infant has a
blood glucose level under 40 mg/dl. 8

9. NURSING STANDARD OF CARE (NSOC) - TREATMENT OF
HYPOGLYCEMIA
Continued
• Interventions
– For Type 1 or Type 2 diabetic patients with a blood glucose level under 70 mg/dl or for gestational
diabetic patients with blood glucose level under 60 mg/dl.
• Give 15 grams of fast acting glucose. Examples include:
– ½ cup of juice without added sugar
– 4 – 6 oz of sugared pop
– 1 cup of milk
– 15 grams of glucose gel.
• If patient is nothing by mouth (NPO)
– If NPO patient does not have an IV, administer Glucagon 0.5 mg intramuscularly or subcutaneously once.
– If NPO patient has an IV, give ½ amp (12.5 gm) of D50 IV push.
– Assess the need for an anti-emetic.
• If blood glucose level is under 50 mg/dl, give the 15 grams of fast acting glucose and also call for immediate
lab blood glucose.
– For Type 1 or Type 2 diabetic patients with a blood glucose level under 40 mg/dl or for gestational
diabetic patients with a blood glucose level under 40 mg/dl,
• Call for immediate lab blood glucose and immediately proceed with treatment
• Give 30 grams of fast acting glucose. Examples include:
– 1 cup of juice without added sugar
– 10 – 12 ounces of sugared pop
• If patient is NPO immediately proceed with treatment and then notify physician
– If NPO patient does not have an IV, administer Glucagon 1 mg subcutaneously once.
– If NPO patient has an IV, give one amp (25 gm) of D50 IV push.
– Assess the need for an anti-emetic.
9

10. NURSING STANDARD OF CARE (NSOC) - TREATMENT OF
HYPOGLYCEMIA
Continued
– Repeat blood glucose level check 15 minutes after administration of fast acting glucose,
Glucagon or D50.
– Repeat steps A or B and C until blood glucose level is above 70 mg/dl or 60 mg/dl if
gestational diabetic patient.
– Once blood glucose is above 70 mg/dl or 60 mg/dl if gestational diabetic patient, follow above
treatment with carbohydrate snack.
• 6 saltines
• 3 graham crackers
• Any other carbohydrate that equals 15 grams
– If a meal is to be within 1 hour it is acceptable to not have the carbohydrate snack and wait
for meal.
– After blood glucose level is above goal, give any previously scheduled anti-diabetic
medication.
– For nursery infant of diabetic mother, follow routine nursery orders for treatment of infant. If
nursery infant of diabetic mother has a blood glucose level less than 40 mg/dl, feed infant.
– Document all blood glucose levels and corrective actions taken on Diabetic Flow Sheet in
patient’s medical record.
• Patient education
– Instruct patient and family or significant other about hypoglycemia including the signs and
symptoms of hypoglycemia, causes of hypoglycemia and interventions for treatment.
– Document patient education appropriately 10

11. NURSING STANDARD OF CARE (NSOC) -
TREATMENT OF HYPOGLYCEMIA
Continued
• References:
• Eli Lilly and Company. (2006). Managing your diabetes: comprehensive
patient education program. Retrieved July 12, 2007 from
http://www.humalog.com/pdf/eli05cl204_yellowbook_final3.pdf
• Porth, C.M. (2004). Essentials of pathophysiology, concepts of altered
health states. Lippincott, Wiliams & Wilkins. Philadelphia, PA.
• Approvals: Policy Review Committee 07/2008, Dr. Kelton Reitz 07/2008,
Mary Sheehan, RN 07/2008
• Senior Leadership Approval: J. Boes 07/2008
• Policy Origination Date:
• Policy Revision Dates: 07/2007, 12/2007, 07/2008, 6/2009, 12/2009,
9/2011
• Policy Reviewed Dates:
11