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diagnostic examination - procedure that involves physical inspection of body structures and
evidence of their function.
laboratory test - procedure that involves the examination of body fluids or specimens.
o comparing the components of a collected specimen with normal findings.
Preprocedural Care - the nurse determines whether the client understands it purpose and the
activities involved.
Positions o dorsal recumbent position - reclining posture with the knees bent, hips rotated outward, and
feet flat.
o knee-chest position - position in which the client rests on the knees and chest.
o lithotomy position - reclining posture with the feet in metal supports called stirrups.
o Sims' position - the client lies on the left side with the chest leaning forward, the right knee
bent toward the head, the right arm forward, and the left arm extended behind the body.
o modified standing position - position in which the upper half of the body leans forward.
General Nursing Guidelines
o
Once he or she obtains the client's consent the nurse prepare the client, obtains equipment
and supplies, and readies the examination area. Often the nurse must repeat, simplify,
clarify, or expand the original explanation.
 withhold food
 modifying the diet
 other necessary preparations
 help client change into an examination gown
 apply identification bracelet
 Report incorrect test preparations promptly
o
To be legally sound consent must contain three elements
 capacity
 comprehension
 voluntariness
o
Radiography - x-rays
o roentgenography - general term for procedures that use roentigen rays or x-rays
 x-rays are avoided during pregnancy if at all possible because a developing
fetus is at greater risk for cellular damage from the x-rays.
 Nursing responsibilities
 assess vital sighs before the examination to provide a baseline and to
help to detect changes in the clients condition during or after the
procedure.
 remove any metal items, including jewelry or wire parts of clothing
 request a lead apron or collar to shield a fetus or vulnerable body
parts during x- rays
 if the radiopraphic study involves administration of a contrast
medium ask the client about allergies especially to seafood or iodine
or previous adverse reactions.
 a reaction can range from mild nausea and vomiting to shock
and death.
 know the location of emergency equipment and drugs in case there is
an unexpected allergic reaction to contrast medium.
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to avoid interference with subsequent visual imaging schedule
procedures requiring iodine before those that use barium.
 To promote urinary excretion encourage the client to drink a large
amount of fluid after an examination involving iodine to promote its
excretion.
 Check on bowel elimination and stool characteristics for at least 2
days after administration of oral barium contrast medium. Barium
retention can lean do constipation and bowel obstruction.
 report absence of bowel elimination beyond 2 days
 contrast medium - substance that adds density to a body organ cavity, such
as barium sulfate or iodine.
 fluoroscopy - form of radiography that displays an image in real time.
 magnetic resonance imaging - technique that produces an image by using
atoms subjected to a strong electromagnetic field.
Endoscopy - optical scopes
 endoscopy - visual examination of internal structures
 sometimes use conscious sedation
 no memory
 more often as an outpatient procedure
o Nursing responsibilities
 to prevent aspiration, withhold food and fluids or advise the client to do so
for at least 6 hours before procedure with the endoscope is inserted into
the upper airway or the upper go tract.
 if conscious sedation is used monitor the clients vital signs, breathing o2
saturation and cardiac rhythm. Have O2 and resuscitation equipment
readily available.
 it topical anesthesia is used to facilitate the passage of an endoscope into
the airway or upper gi tract withhold foods or fluids for at least 2 hours
after the procedure or until swallow cough and gag reflexes return.
 relieve the client's sore throat with ice chips, fluids, or gargles when it is
safe to do so.
 confirm that a bowel preparation using laxatives and enemas has been
completed before endoscopic procedures of the lower intestine.
 report difficulty in arousing a client or any sharp pain fever, unusual
bleeding, nausea, vomiting or difficulty with urination after any endoscopic
examination.
Radionuclide imaging - radioactive chemicals
o Radionuclide Imaging
 radionuclide's - elements whose molecular structures are altered
 cold spot - area with little or no radionuclide concentration.
 hot spot - area where radionuclide is intensely concentrated.
 nuclear medicine department - unit responsible for radionuclide imaging.
 positron emission tomography -(PET scan)- radionuclide scanning with the
layered analysis of tomography.
 computed tomography - ( CT scan)-form of roentrgenography that shows
planes of tissue
o Nursing Responsibilities
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Inquire about a woman's menstrual and obstetric history. Notify the
nuclear medicine department if the client is pregnant, could possibly be
pregnant or is breast feeding.
 ask about the allergy history because iodine commonly is used in
radionuclide examinations.
 assist the client with a gown , robe and slippers, make sure the client has no
internal metal devices or external metal objects because these interfere
with diagnostic findings.
 obtain an accurate weight because the dose of radionuclide is calculated
according to weight.
 inform the client that he or she will be radioactive for a brief period (
usually less than 24 hours) but that body fluids, such as urine, stool, and
emesis, can be safely flushed away.
 instruct premenopausal women to use effective birth control for the short
period during which radiation continues to be present.
Ultrasonography - high frequency sound waves
 ultrasonography - soft tissue examination that uses sound waves in ranges beyond
human hearing. also known as echography.
 echcography -(Ultrasound) - soft tissue examination that uses sound waves in ranges
beyond human hearing.
o transducer - instrument that receives and transmits biophysical energy.
o Related Nursing Responsibilities
 for best visualization schedule abdominal and pelvic ultrasonography
before any examinations that use barium
 Instruct clients undergoing abdominal ultrasonography to drink five to six
full glasses of fluid approximately 1 - 2 hours before the test. To ensure a
full bladder they should not urinate until after the test is completed
 Explain that acoustic gel is applied over the area where the transducer is
placed.
Electrical graphic recordings
 electrocardiography -(ECG or EKG)- examination of the electrical activity in
the heart.
Related Nursing Responsibilities
 Clean the skin and clip hair in the area where the electrode tabs will
be placed to ensure adherence and reduce discomfort on removal
 attach the adhesive electrode tabs to the skin where the electrode
wires will be fastened
 avoid attaching the adhesive tabs over bones, scars, or breast tissue.
 electroencephalography -(EEG) -examination of the energy emitted by the
brain.
 instruct the client to shampoo the hair the evening before the
procedure to facilitate firm attachment of the electrodes. He or she
should shampoo the hair after the test to remove adhesive from the
scalp.
 withhold coffee tea and cola beverages for 8 hours before the
procedure. Consult with the physician about withholding scheduled
medications. especially those that affect neurologic activity.
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is a sleep -deprived EEG is scheduled, instruct the client that he or she
must stay awake after midnight before the examination
 electromyography - (EMG)-examination of the energy produced by
stimulated muscles.
 tell the client he or she will be instructed to contact and relax certain
muscles during the examination.
 explain that electrical current is applied to muscles during and EMG
but that the sensation is not usually painful. Also a muscle electrode
is inserted with small gauge needle in 10 or more locations but the
experience is painless unless it touches a terminal nerve in the area.
Assisting with a Paracentesis o paracentesis - procedure for withdrawing fluid from the abdominal cavity
 WHY?
o relieve abdominal pressure
o improve breathing
o may send specimen to lab
 Nursing Guidelines
o explain the procedure or clarify the physicians explanation to the client
 explanations prepare the client for an unfamiliar experience
 promote a clearer understanding
o ensure that the client has signed the consent form if needed
 a consent form provides legal protection
o measure and record weight, blood pressure, and respiratory rate; measure
abdominal girth at its widest point with a tape measure.
 this data serves as a basis for post procedural comparisons
o obtain a prepackaged paracentesis kit along with a vial or local anesthetic
 gathering supplies promotes efficient time management
o make sure that extra gloves, gown, mask, and goggles are available
 self protection
o encourage the client to empty the bladder just before the procedure
 an empty bladder prevents accidental puncture of the bladder
o place the client in a sitting position
 This position pools abdominal fluid in the lower areas of the abdomen and
displaces the intestines posteriorly.
o Hold the container of local anesthetic so the physician can withdraw a sufficient
amount.
 doing so prevents contaminating the physician's sterile gloves
o offer the client support as an area of the abdomen is anesthetized then pierced
with an instrument called a trocar and a hollow sheath called a cannula is
inserted.
 empathetic concern helps to relieve anxiety
o Reassess the client periodically after cannula insertion; expect that blood
pressure and respiratory rate may decrease.
 assessment indicates the clients response.
o Place a band aid or small dressing over the puncture site after withdrawal of the
cannula.
 the dressing acts as a barrier to microorganisms and absorbs drainage
o assist the client to a position of comfort.
 demonstrates concern for the client's welfare.
Measure the volume of fluid withdrawn
 this measurement contributes to accurate assessment of fluid volume
o Label the specimen, if ordered and send it to the laboratory with the appropriate
requisition form
 facilitates appropriate analysis.
o Document pertinent information such as the appearance and volume of the fluid,
client assessments and disposition of the specimen
 adds essential data to the client's medical record.
Assisting with a Lumbar Puncture
o lumbar puncture - (Spinal tap) -procedure that involves insertion of a needle between lumbar
vertebrae in the spine but below the spinal cord itself.
 WHY?
o diagnose conditions that raise the pressure with the brain such as brain or spinal
cord tumor
o diagnose meningitis
o also removed before instilling contrast medium for x-rays of the spinal column
o treatment of some conditions to instill drugs directly into the spinal fluid after
withdrawal of a similar amount.
 Nursing Guidelines
o explain the procedure or clarify the physicians explanation to the client
 explanations prepare the client for an unfamiliar experience
 promote a clearer understanding
o ensure that the client has signed the consent form if needed
 a consent form provides legal protection
o Perform a basic neurologic examination including pupil size and response and
muscle strength and sensation in all four extremities
 provides a baseline for comparison
o Encourage client to empty the bladder
 promotes comfort during the procedure
o administer a sedative drug if ordered
 reduce anxiety
o Obtain a prepackaged lumbar puncture kit along with a vial of local anesthetic.
 gathering supplies promotes efficient time management
o Make sure that extra gloves, gown, mask, and goggles are available
 personal protection
o Place the client on their side with the knees and neck acutely flexed or in a sitting
position bent from the hips.
 these positions separate the bony vertebrae
o instruct the client that once the needle is inserted, they must avoid movement
 prevents injury
o Hold the container of local anesthetic so the physician can withdraw a sufficient
amount
 prevents contaminating the physicians gloves
o Stabilize the clients position at the neck and knees
 this reinforces the need to remain motionless
o support the client emotionally as the needle is inserted and the skin is injected
with local anesthesia
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 empathetic concern helps to relieve anxiety
tell the client that it is not unusual to feel pressure or a shooting pain down the
leg.
 prepares the client for expected sensations
o Perform Queckenstedt's test, if asked by compressing each jugular vein separately
for approximately 10 seconds while pressure is being measured.
 helps demonstrate if there is an obstruction in the circulation of spinal fluid,
If so the pressure remains unchanged, rises slightly or takes longer than 20
seconds to return to baseline.
o observe that the physician fills three separate numbered containers with 5 to 10
ml. in their appropriate sequence is laboratory analysis is desired.
 if blood is present but in the least amount in the third container. Its source
is most likely trauma for the procedure rather than CNS pathology.
o Place a Band-Aid or small dressing over the puncture site after the needle has
been withdrawn.
 The dressing acts as a barrier to microorganisms and absorbs drainage.
o Position the client flat on the back or abdomen; instruct the client to remain flat
and roll from side to side for the next 6 to 12 hours.
 these measures reduce the potential for severe headache
o Reassess the clients neurologic status, Check the puncture site for bleeding or
clear drainage
 Comparative data help the nurse to evaluate changes in the clients
condition.
o Offer oral fluids frequently
 They restore the volume of spinal fluid
o Label the specimens if ordered and send them to the lab
 facilitates appropriate analysis
o Document pertinent information such as the appearance of the fluid client
assessments and disposition of the specimen
 adds essential data to the clients medical record.
Collecting a specimen for a throat culture
specimens - samples of tissue or body fluids
 incubation of microorganisms
 WHY?
o to identify and treat the cause of an infection
o Gram staining - process of adding dye to a microscopic specimen to aid in the
identification of the microbe.
o a culture may be repeated after a course of treatment to determine its
effectiveness
 Nursing Guidelines
 Check with the physician about proceeding with the throat culture if the client is taking
antibiotics.
o antibiotics affect test results
 Delay collecting a specimen if the client has recently used an antiseptic gargle
o such gargle affects the test diagnostic value
 Explain the purpose of and technique for obtaining the culture
o helps reduce anxiety and promote cooperation
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collect supplies: sterile culture swab, glass slide tongue blade, gloves, mask, if the client
is coughing paper tissues and an emesis basin if the client gags
o efficient time management
 Have the client sit where light is optimum
o light enhances inspection of the throat anatomy
 Don gloves and mask if necessary
o their usage reduces the potential for transferring microorganisms
 loosen the cap on the tube in which the swab is located
o facilitates hand dexterity
 tell the client to open the mouth wide, stick out the tongue and tilt the head back.
o promotes access to the back of the throat
 Depress the middle of the tongue with a tongue blade in your nondominant hand
o opens the pathway for the swab
 Rub and twist the tip of the swab around the tonsil areas and back of the throat without
touching the lips teeth or tongue,
o transfers microorganisms from the inflamed tissue to the swab
 Be prepared for the client's gagging
o stimulates gag reflex
 remove the swab and discard the tongue blade in a lined receptacle
o controls the spread of microorganisms
 Spread the secretions on the swab across the glass slide
o prepares a specimen for quick staining and microscopic examination
 replace the swab securely within the tube taking care not to touch the outside of the
container
o this method avoids collecting unrelated microorganisms and provides
containment for the collected specimen.
 Crush the packet in the bottom of the tube
o crushing releases nourishing fluid to promote bacterial growth
 remove gloves discard them in a lined receptacle and wash your hands or perform hand
antisepsis.
o to reduce the transmission of microorganisms
 Label the culture tube with the client's name, the date and time and the source of the
specimen
o to provide laboratory personnel with essential information
 Attend to staining and examination of the prepared glass slide, if appropriate.
o it provides tentative identification of streptococcal bacteria
 Deliver the sealed culture tube to the laboratory or refrigerate it if thee will be a delay
of longer than1 hour.
o to ensure that the microorganisms will grow when transferred to other culture
media.
pelvic examination - physical inspection of the vagina and cervix, with palpitation of the uterus and
ovaries.
o Pap(Papanicolaou) test - screening test that detects abnormal cervical cells, the status of
reproductive hormone activity, or the presence of normal or infectious microorganisms in the
uterus or vagina.
o Assessment
 Determine the identity of the client on whom the examination will be performed.
 prevents errors
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Determine if a Pap test is needed
 AMA recommendations
 receive first pap test approximately 3 years after the onset of vaginal
intercourse but no later than 21 years of age.
 have annual pap test thereafter until 30 years of age
 be screened every 2-3 years at or after 30 years of age when three prior
consecutive tests were normal or negative.
 at or beyond age 65 with a pap test on a case by case basis.
 Indicates the need for additional equipment and supplies
 Find out if the client has had a pelvic examination before.
 provides a basis for teaching
 Ask if the client is currently menstruating or has had intercourse with the last 48 hours
 Blood mucus and pus are three substances that obscure and distort cells making it
difficult to determine if they are atypical and interfering with the microscopic
examination of collected specimens. The examiner may wish to delay obtaining a
specimen.
 inquire if the client has douched in the last 24 hours.
 Suggests a need to reschedule the Pap smear because an adequate sample of
cells and secretions may not be available
 Ask the clients age, date of last menstrual period number of pregnancies and live births
and description of symptoms such as bleeding or drainage itching or pain
 provides data to determine the possibility of pregnancy to compare cellular
specimens with hormonal activity and to provide clues as to possible pathology
and the need for additional tests.
 Determine if and what type of birth control the client is using, if she is premenopausal,
For oral contraceptives identify the name of the drug and dosage.
 Correlates the influence of prescribed hormones on cellular specimens.
 Ask menopausal women if they are taking hormone replacement and the brand name
and dosage
 correlates the influence of prescribed hormones on cellular specimens.
 observe for impaired strength or joint limitation
 Suggests the need to modify the examination position.
Planning
 Explain the procedure and give the client an opportunity to ask questions
 to reduce anxiety
 provide and examination gown and direct the client to empty her bladder
 facilitates palpation of the uterus and ovaries
 Place a speculum ( a metal or a disposable plastic instrument for widening the vagina)
gloves examination light, lubricant and the following materials for the Pap smear: long
soft applicators and spatula and at least three glass slides, a chemical fixative and a
container for holding the slides on the counter or on a tray in the examination room.
 time management
 Mark one slide with an E for endocervical, another with a C for cervical, and the last
with a V for Vaginal
 identify the locations from which the specimens are taken
 Arrange for a female nurse to be with the client during the examination, especially if
the examiner is a man
 reduces the potential for claims of sexual impropriety
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Plan to assist with the collection of the vaginal and cervical secretions for the Pap test
before the examiner proceeds to palpate the internal organs.
 Prevents lubricant used during palpation form interfering with microscopic
examination of the specimens.
o Implementation
 Place the clients legs in stirrups to facilitate a lithotomy position or use an alternative
position such as Sims or dorsal recumbent if the client is disabled.
 provides access to the vagina
 cover the client with a cotton or paper drape
 maintains modesty and privacy
 introduce the examiner to the client if the two are strangers
 tends to reduce anxiety
 fold back the drape just before the examination begins
 Exposes the genitalia while minimizing client exposure
 direct the examination light form behind the examiners shoulder toward the vaginal
opening.
 illuminates the area facilitating inspection
 Wet the speculum with warm water; if a Pap smear will not be obtained, apply water
soluble lubricant to the speculum blades
 eases and provides comfort during insertion
 prepare the client to expect the momentary insertion of the speculum. Explain that she
will hear a loud click as it locks in place
 tends to reduce anxiety and aids in relaxation
 hand the examiner a soft tipped applicator, spatula and brush applicator in that order
 collection for the secretions for the Pap smear
 Hold the slide marked E so the examiner can roll or slide the specimen across the slide
follow a similar pattern as the second and third samples are collected
 position the lined receptacle so the examiner can dispose of the collection devices and
the speculum after use
 place each slide in a chemical fixative solution or spray it with a similar chemical
lubricate the gloved fingers of the examiners dominant hand and prepare the client for
an internal vaginal and in some rectal examination
 reduces friction and keeps the client informed of the progress of the examination
 Don gloves and clean the skin of lubricant when the examination is completed: then
remove the gloves
 Wash hands
 prevents transmission of microorganisms; promotes comfort and hygiene
 Lower both feet simultaneously from the stirrups and assist the client to sit up
 reduces strain on abdominal and back muscles
 assist the client from the room after she has dressed
 client safety
Assisting with a Sigmoidoscopy
o Assessment
 identify the client on whom the examination will be performed
 prevents errors
 Check for a signed consent form
 provides legal protection
 ask the client to describe the procedure
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indicates the accuracy of the client's understanding and provides and opportunity
to clarify the explanation
 Inquire about the clients current symptoms and family history of significant diseases
 provides information about the purpose for performing the procedure and an
opportunity for reinforcing the need for future regular sigmosidscopic
examinations
 ask for a brief description of the clients dietary and fluid intake and bowel cleansing
protocol and results
 indicates if the client complied with proper preparation for the procedure
 assess the client's vital signs and obtain other physical assessments according to agency
policy, such as weight, or bowel sounds.
 provides a baseline for future comparisons
 Ask for an allergy history and a list of medications being taken
 influences drugs that may be prescribed and alerts staff to other medical
problems.
Planning
 Direct the client to undress don an examination gown and use the restroom
 Facilitates the examination and gives the client an opportunity to empty the
bowel and bladder again.
 Prepare for the examination by placing a sigmoidoscope gloves, gown, mask , goggles,
lubricant, suction machine, and containers for biopsied tissue in the examination room.
 efficient time management
 Check the light at the end of the sigmoidoscope and the suction equipment are
operational
 avoids delay inconvenience and discomfort once the examination is in progress
Implementation
 Help the client to assume a Sims position if a flexible sigmoidoscope will be used or a
knee-chest position if a rigid sigmoidoscope, which is less common is used
 facilitates passage of the scope; an endoscopic table may be used in lieu of a self
maintained knee chest position
 Cover client with a cotton or paper drape
 maintains modesty and privacy
 Introduce the examiner to the client if the two are strangers
 to reduce anxiety
 Lubricate the examiners gloved fingers
 reduces discomfort when the fingers are used to dilate the anal and rectal
sphincters.
 Prepare the client for the introduction of the examiner's fingers, followed by the
insertion of the sigmoidoscope
 to reduce anxiety by keeping the client informed of each step and the progress
being made.
 Acknowledge any discomfort that the client may be experiencing; explain that it should
be short-lived.
 to empathize with the clients distress
 Inform the client if, and before suction is used, air is introduced or a sample of tissue is
obtained.
 prepares the client for unexpected sensations or temporary increase in
discomfort
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Open the specimen container, cover the specimen with preservative and recap the
container
 prevents loss and decomposition of the specimen
 Inform the client when the scope will be withdrawn.
 to keep the client informed of progress
 Don gloves and clean the skin of lubricant and stool after the examination is completed.
 to prevent the transmission of microorganisms and promote comfort and
hygiene.
 wash hands or perform hand antisepsis
 assist the client from the room to an area where his or her clothing is located or provide
a clean gown
 Explain that there may be slight abdominal discomfort until the instilled air has been
expelled and that the client may observe some rectal bleeding if a biopsy was taken
 Stress that if severe pain occurs or bleeding is excessive the client should notify the
physician.
 identifies significant data to report
 advise that the client may consume food and fluids as desired
 Clean the sigmoidoscope and any other soiled equipment according to agency and
infection control guidelines.
 restore order and cleanliness to the examination room: restock supplies
 complete laboratory requisition form label specimen and ensure that the specimen is
transported to the laboratory for analysis
o Evaluation
 client demonstrated understanding of the purpose for the examination
 appropriate dietary and bowel preparations were carried out
 client assumed required position
 comfort and safety were maintained
 prost procedural instructions were given
 specimen was preserved, identified and delivered appropriately.
o Document
 Date and time
 pertinent preassessment data if any
 type of examination and specimen collected if any
 examiner and or location
 condition for the client after the examination
 instructions provided
 Disposition of specimens.
Measuring Capillary Blood Glucose
 morning fasting - 70 -99
 may rise to 139 within 2-4 hours of eating
o glucometer - instrument that measures the amount of glucose in capillary blood
 Several types of glucometers are available
 follow manufacturers instruction for accurate use.
 Measure 30 minutes before eating and before bedtime
 Measuring blood glucose involves a risk for contact with blood
 always wear gloves
Using a Glucometer
o Assessment
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o
determine that a test using one or more control solutions has been performed on the
glucometer since midnight in a health agency. Identify the client on whom the
examination will be performed.
 Find out if the client has ever had a blood glucose level measured with a glucometer or
if the client has any questions
 provides a basis for teaching
 review previous blood glucose level and trends that may be obvious
 helps to evaluate the reliability of the assess measurement when it is obtained
 Check to see if insulin coverage has been ordered if glucose levers are higher than
normal
 aids in quickly reducing high blood glucose levels
 check the date on the container of test strips; discard if the date has expired
 discard unused test strips stored in a vial 4 months after they are opened.
 observe the code number on the container of test strips compare it with the code
number programmed into the glucometer
 code numbers range from 1 to 16; if the numbers do not match, the meter
number is changed
 inspect the clients fingers and thumb for a nontraumatized area; also inspect the
earlobes; an acceptable alternative.
Planning
 test the machine's calibration with a control strop or solution supplied by the
manufacturer, if it has not been done since midnight.
 Arrange care so that the test is performed approximately 30 minutes before a meal and
at bedtime.
 collect the necessary equipment and supplies' glucometer, lancets, lancet holder test
strips and gloves
 Ask the client to wash hands with soap and water and towel dry
 reduces microorganisms on the skin; warmth dilates the capillaries and increases
blood flow. Swabbing with alcohol is not necessary and can alter the results if not
totally evaporated.
 Turn on machine, observe that last blood glucose reading current test strip code, and
the message insert strip
 Place the notched end of one test strip into the test strip holder with the test spot up
 assemble the lancet within the spring loaded lancet holder
 Don clean gloves after washing your hands or performing hand antisepsis
 select a nontraumitixed side of a clients finger or thumb avoid the central pads
 apply the lancet firmly to the side of the finger and press the release button
 release lancet and holder
hold the finger or thumb so that a large hanging drop of blood forms
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 touch the hanging drop of blood to the test spot on the strip making sure that the spot
is completely covered and stays wet during the test
 listen for the meter to beep followed by a series of beeps 45 seconds lager
 read the display on the meter after the series of beeps
 turn the machine off
 Offer the client a Band-Aid or paper tissue
 release the lancet into a puncture resistant container
 clean the window of the glucometer and the hole of the test strip holder with a cotton
swab or damp cloth to remove dirt, blood or lint at least once a week
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remove gloves and immediately wash your hand or perform hand antisepsis
remove equipment form the bedside if it does not belong to the client
store the test strips in a cool dry place
record the glucose measurement in the client's diabetic record
report the blood glucose level to the nurse in charge
Evaluation
 client demonstrates understanding of the purpose for the examination
 adequate blood is obtained
 results are consistent with the client's present condition, previous trends, and
concurrent treatment
 additional treatment is provided depending on glucose measurement
Document
 Date and time
 pertinent preassessment data if any
 results obtained when using the glucometer, in most agencies the test data are
recorded on a diabetic flow sheet rather than charted in a narrative nursing notes
 treatment provided based on abnormal test results,