Page 948 - Saunders Comprehensive Review For NCLEX-RN

indicating the type and daily insulin dosage
prescribed for the child.
10. See Chapter 47 for information on insulin types,
administration sites, and administration procedure.

H. Blood glucose monitoring

1. Results provide information needed to maintain good
glycemic control.
2. Blood glucose monitoring is more accurate than urine
testing.
3. Monitoring requires that the child prick himself or
herself several times a day as prescribed (Box 32-2).
4. Instruct the child and parents about the proper
procedure for obtaining the blood glucose level.
5. Inform the child and parents that the procedure must
be done precisely to obtain accurate results.
6. Stress the importance of hand washing before and
after performing the procedure to prevent infection.
7. Stress the importance of following the manufacturer’s
instructions for the blood glucose monitoring device.
8. Instruct the child and parents to calibrate the monitor
as instructed by the manufacturer.
9. Instruct the child and parents to check the expiration
date on the test strips used for blood glucose
monitoring.
10. Instruct the child and parents that if the blood glucose
results do not seem reasonable, they should reread
the instructions, reassess technique, check the
expiration date of the test strips, and perform the
procedure again to verify results.
I. Urine testing
1. Instruct the parents and child in the procedure for
testing urine for ketones and glucose.
2. Teach the child that the second voided urine

specimen is most accurate.
3. The presence of ketones may indicate impending
ketoacidosis.

Urine glucose testing is an unreliable method of monitoring the

glucose level; however, the urine should be tested for ketones when the
child is ill or when the blood glucose level is consistently greater than
200 mg/dL (greater than 11.4 mmol/L) or as specified by the PHCP.

J. Hypoglycemia

1. Description

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