Medical Surgical Diabetes #8

Question

A nurse is instructing through Teach Back to a client learning how to perform self-blood glucose monitoring. The nurse evaluates the instruction and identifies the need for additional teaching because of which of the following client statements?

Answers

  1. “ I will keep a log of glucose results to monitor for trends.”
    • Rationale:

      This answer is not correct because the client does not need further teaching since keeping a log of blood glucose measurements will help assess trends in the client’s blood glucose. This log will be shown to the health care provider to determine if any changes need to be made in the client’s treatment plan.

  2. “I will try to maintain my blood sugar values around 110 mg/mL.”
    • Rationale:

      This answer is not correct because the client does not need further teaching since maintaining a blood glucose around 110 mg/mL will keep the blood glucose in a range that is not too high and not too low. This will prevent hypoglycemia and complications associated with elevated blood glucose levels.

  3. “I will always wash my hands prior to puncturing the finger pad.”
    • Rationale:

      This answer is not correct because the client does not need further teaching since washing the hands prior to puncturing the finger will provide infection control and if the water is warm, it may help blood flow easier for a better sample. An adequate sample will provide a more accurate result.

  4. “I will puncture my finger in the center of the finger pad.”
    • Rationale:

      This answer is correct because the client does need further teaching since puncturing the finger pad in the center is not appropriate. The client should be taught that testing blood through a puncture to the middle of the finger pad is painful and may not have better blood flow compared to the site off-center. Rotating finger tips is also advised.

Overview

Proper self-blood glucose monitoring is essential for the client with diabetes. The client should be taught that testing blood through a puncture to the middle of the finger pad is painful and may not have better blood flow compared to the site off-center.

Explanation

Learning Outcomes

Self-blood glucose monitoring is essential to proper control of blood glucose for the client with diabetes. Proper methods are taught by the nurse in the hospital or facility so accurate blood glucose measurements are obtained. The Teach Back return demonstration method is helpful to use to assess if the client understands and is capable of performing self-blood glucose monitoring. Various teachings are included in the education including the importance of puncturing the finger to the side of the finger, not in the center of the finger pad. Puncturing to the middle of the finger pad is painful and may not have better blood flow compared to the site off-center. Other teaching includes keeping a log of blood glucose measurements, maintaining blood sugar levels around 110 mg/mL, and to always wash hands before puncturing the finger pad.

Test Taking Tip

Diabetic teaching is an emphasis on nursing school exams, standardized exams, and NCLEX. Be sure to be prepared regarding all aspects of diabetic client teaching, including the condition, blood glucose monitoring, medication administration, hyperglycemia, and hypoglycemia.

Video Rationale