Patients with diabetes face the daily challenge of keeping their blood glucose levels as close to normal as possible through a complex treatment regimen that demands many lifestyle changes. To monitor their blood glucose levels closely, patients need to use a blood glucose meter at least four times a day. Then based on the results, they can adjust their diet and medication dosages accordingly.

Use the following teaching guide to help your patient understand self-monitoring and to promote her comfort.

Preparing for The Test

Most patients check their blood glucose levels at specific times during the day, usually before meals and before bedtime. Teach your patient to choose a clean, well-lit location to perform the test, for example, the kitchen table. Then explain that she'll need to assemble the following supplies:

lancet or self-sticking device

glucose meter

test strip

cotton ball

pen and paper or logbook to record results.

Remind her to check that the batteries in the meter are fresh and that the test strips aren't outdated . Most meters require calibration on a regular basis. Tell your patient to follow the manufacturer's recommendations for calibration procedures.

Performing The Test

Instruct your patient to wash her hands with warm soapy water. Doing so will not only help prevent infection but will also promote blood flow to the skin surface so that she can obtain an adequate drop of blood.

Tell your patient to turn on the blood glucose meter and insert the test strip before she sticks her finger for blood.

Explain that she should choose an injection site along the side or top of her fingertip. Tell her to avoid the center of the finger pad because she has more nerve endings there. Advise her that her fingers may be sore for the first few days and that she can either rotate the sites to help ease the discomfort or use the same site over and over again so that a callus forms, making subsequent finger sticks virtually painless.

As she sticks her finger, instruct her to firmly squeeze it with the thumb and forefinger of her other hand. This will help to express the blood and reduce sensation to the site.

After she sticks her finger, instruct her to squeeze it until a full, hanging droplet of blood forms,

Then tell her to drop the blood directly onto the test strip. Caution her not to smear the blood onto the strip or to touch it with her finger. Explain that the natural oils on her skin can interfere with the test results.

Instruct her to cover the target area on the test strip completely,

Now tell the patient to apply gentle pressure to the puncture site with a cotton ball to stop the bleeding,

Blood glucose readings appear on the meter's display window in 45 to 60 seconds, Show your patient how to record the results along with the date, time, and any other appropriate information.

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