what would you do??

leslie :-D · Jan 24, 2009

Took my pt's AC blood sugar and it was 60. She said she didn't feel low at all. Rechecked it immediately after and it was 138.
How do you know which one to go by/what do you do?

i wouldn't feel very comfortable w/that glucometer...

if she's due for insulin or oral hypoglycemic, i'd probably give it w/some juice.

leslie

Melinurse · Jan 24, 2009

I'd do a quality control check on that glucometer.

Shenanigans, RN · Jan 24, 2009

Just did my glucometre training the other day actually. It said if you get random results that you have to either wash your and the pt's hand, disguard the first drop of blood, check to make sure the strips aren't expired, even extremes of temps and humidity can cause problems.

Otherwise, I'd get another glucometre - or use the pt's. Give the insulin. Then tell my senior nurse.

malaski · Jan 24, 2009

At the hospital I'm at, we have to test our glucometers once a day on the unit - it won't let you get in unless you qc it first. I would be concerned about the possibility of a faulty monitor

missouriman · Jan 25, 2009

high blood sugar is not all that critical. Low is. during really low bs the body will start to (eat) the brain.

I would have given juice and sugar. and I would have checked a third time. before the juice.. or tried a second machine.

I have seen people die from low blood sugar, but I have never seen anyone die from it being high.

eating the brain is a bit out of line, but brain damage can result from low blood sugar.

pretty wild that the brain can use up 25 percent of the bodies glucose.

mscsrjhm · Jan 25, 2009

Had a nursing student/CNA take a blood sugar once on a MR patient. Over 200- his accuchecks had always been normal. She assured me that she had used alcohol to wipe his finger. Going to check it myself- his fingers were dripping with ice cream.

I use alcohol wipe- dry with cotton ball, then stick.

Get a new machine- something's not right.

BroadwayRN, ASN, RN · Jan 25, 2009

We have to calibrate our glucometers at the beginning of each shift. If we think one of them is questionable we draw a BG and have it run stat by the lab. If it's equal with the glucometer, cool. If it's off by more than 15 points then we go by the blood test and turn the glucometer into the lab for a loaner.

CaLLaCoDe, BSN, RN · Jan 25, 2009

I think I would have checked the pt's bedside table for some goodies!

I would then have checked the sugar with another machine.

If still in question called for a serum glucose or checked the morning BMP daily trends for further data on this patient.

miko014 · Jan 25, 2009

I use alcohol wipe- dry with cotton ball, then stick.
Get a new machine- something's not right.

If you touch the site with anything after you use the alcohol wipe, you are recontaminating. The site needs to air dry and needs to be completely dry before the stick for the result to be accurate.

I agree with the try another machine part - I wouldn't want to cover without knowing for sure what the real number was.

Vito Andolini · Jan 25, 2009

just did my glucometre training the other day actually. it said if you get random results that you have to either wash your and the pt's hand, disguard the first drop of blood, check to make sure the strips aren't expired, even extremes of temps and humidity can cause problems.
otherwise, i'd get another glucometre - or use the pt's. give the insulin. then tell my senior nurse.

i would do all of the above except give the insulin. i would go by the lower figure. it's safer. of course, if the patient would allow it, i'd do a 3rd check after doing all of the above. it could be you need a new battery, too. try replacing it.

if you gave the insulin and then told the senior nurse, what could she do about it? if you're going to involve her, telling her before you give the insulin seems to makes more sense. just a thought, sorry if i sound critical. just my :twocents:

nerdtonurse?, BSN, RN · Jan 25, 2009

If the pt's asymptomatic, I'd wash their hands, dry them, use alcohol prep, let it dry, and then test it again. If it's still showing inprobably low, I'd get the lab to draw a glucose. I had a pt one night that was low, and symptomatic (30!). I ran to the dibold, got d50, came in, pushed it, waited a few minutes (pt was "waking up") and took the sugar again -- 325! When I've pushed d50, it usually just raises the fsbs about 100 points. I'm in the room, wondering, WTH!? as I'm looking at the reading, and the daughter pops up and says she pulled her glucagon out of her purse and gave her that as well, and spooned a bunch of sugar into her mouth while I was gone for the d50. I didn't strangle her, but I thought about it...I could just see trying to explain how my pt had aspirated a pound of Dixie Crystals...

Maybe she self medicated while you were out of the room?