Difference in gluco checks

  1. First gluco check was done on left hand index finger, 314. VERY high for resident. After joking with her that I would do a recheck on her right pinkie finger because maybe it would be lower (because the finger is smaller), 145. normal for resident.
    Why such a difference?
    I used the same type of test strips, same glucometer, same type alcohol swabs.
    Only thing I can think of is maybe I didn't clean her finger off good enough and there was some food or something left over that was picked up in the high reading.
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  2. 13 Comments

  3. by   amoLucia
    My first thought was to think something was funky about the glucometer!!! Those little things take such a brutal beating with high usage, drops on the floor, and all those in-between cleanings. I have to use them on the floor but whenever I get such disparate results, I get another meter. I just don't trust those little buggers!

    Also, think about operator error - was the blood drop juicy enough? A skimpy sample can give a lower reading. Did the test strips match the bottle? Frequent BIG BIG error. Are your machine calibrated/checked as required? Most places do QA checks each shift. Do a test with the hi-lo reagents. You may need to change the strips and bottle chip and try again.

    Two so different readings would not be enough for me to proceed with an intervention until I was ABSOTIVELY, POSOLUTELY :redlight: comfortable with the results.
  4. by   BrandonLPN
    Also, if you don't let the alcohol dry before doing the fingerstick, that can give a false high.
  5. by   TheCommuter
    A finger stick blood glucose sample that has too much interstitial fluid can result in a falsely low reading.

    Also, if the patient has ever had a stroke (CVA) in the past, do not obtain the blood glucose sample on the affected side.
  6. by   RNewbie
    I dont trust the machines either. I was taught to never use the thumb or pinky because they give abnormally high and low values.
  7. by   Kittypower123
    I was taught to never use the thumb or pinky because they give abnormally high and low values.
    Interesting - I had not heard that before. I actually have a resident that only has a thumb and a pinky (the others have been amputated).
  8. by   Been there,done that
    Quote from Kittypower123
    Interesting - I had not heard that before. I actually have a resident that only has a thumb and a pinky (the others have been amputated).
    I've been a nurse TOO long , I found that funny.
  9. by   AgentBeast
    Handheld glucometers are highly inaccurate. Per the ISO standards they only need to be within plus or minus 20% of laboratory standards 95% of the time.
  10. by   Pedsnurse77
    Quote from Been there,done that
    I've been a nurse TOO long , I found that funny.
    Omg me too! I've done forearms for this reason.
  11. by   BrandonLPN
    I use the thumb all the time. Toes sometimes, too. I'm still always in the pts normal range.
  12. by   MJeanRN
    "Milking" the finger after the stick can result in interstitial fluid being mixed with blood and causing abnormal glucometer readings as well. Make sure you're getting good circulation prior to a finger stick.
  13. by   laderalis
    I didn't "milk" the finger after. Alcohol was dry. Glucometer is checked q day. They were fingers I normally use.
    I still think there must have been something on her finger. *shrug*
  14. by   classicdame
    As a diabetic I would not use my toes or any one else's for glucose monitoring. Too much risk for circulation problems that may result in foot infection. Home meters allow for palm and forearm use. I have used hospital meter when testing earlobe (both hands and feet were covered in bandages due to body burn). Always retest when not sure of the result and do check the meter for any needed maintenance or uploading.

    PS don't forget to clean meter between patients.

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