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SWCS Volunteer Diabetes Training 2014
Transcript of SWCS Volunteer Diabetes Training 2014
Checking blood glucose (BG)
What is Diabetes?
Highs and Lows
Blood Glucose Monitoring
Monday, November 3 , 2014
Vol XCIII, No. 311
Checking urine for ketones
Highs and Lows
Ketones are substances the body produces when it is unable to effectively use the carbohydrates eaten. Ketones occur when Diabetes is getting out of control. A simple urine test is used to see if there are ketones in the urine. Most students can perform this procedure and just need someone to verify the color of the pad on the stick at the appropriate time. Always encourage students to do this procedure whenever possible, but if you have to assist in any way other than verifying the color of the pad, be sure to wear protective gloves.
NOTE: Presence of ketones in the urine can turn into a medical emergency if left untreated. Follow the student's health care plan and call parents immediately if small, moderate or large amounts of ketones are present in the urine.
SWCS Volunteer Diabetes Training
Thank you for volunteering to provide support for our students with Diabetes. This module is designed to help you understand what Diabetes is and give you an overview of how to care for a student with Diabetes. Each student is different, and therefore, each will have his/her own medical orders and either a 504 Health Care Plan or an Individualized Care Plan that will outline the specifics of their care.
Always refer back to the individual student's medical orders and 504 individualized health plan and/or individualized care plan for instructions specific to the student you're assisting. Also remember, many students are able to perform the procedures outlined in this training module with minimal supervision. Always encourage students to perform all procedures whenever possible. Last, be sure to wear protective gloves any time you're assisting with a procedure that may expose you to blood or body fluids.
Upon completion of this module learners will:
1. Describe what Diabetes is.
2. Describe how to check blood glucose levels
3. Recognize the symptoms of high and low blood
4. Describe how to treat high and low blood glucose
5. Calculate insulin doses accurately following
primary care provider's orders.
6. Demonstrate how to safely monitor and/or
administer insulin using various methods.
7. Understand the basics of documentation.
What is Diabetes
Even when people take good care of themselves, they will sometimes experience high blood glucose. Guidelines of what's considered a high blood glucose and how to treat it will be outlined in each student's primary care provider's orders and 504 Health Plan or individualized care plan but generally speaking, a blood glucose above 250 mg/dl is considered high. The higher the blood glucose, the more extreme the symptoms.
SYMPTOMS OF HYPERGLYCEMIA
1. Feeling thirsty
2. Frequent urination
3. Feeling tired
4. Feeling itchy all over
5. Difficulty concentrating
6. Fruity smell to breath
7. Stomach pain, nausea
HIGH BLOOD GLUCOSE = HYPERGLYCEMIA
GUIDELINES TO TREATING HYPERGLYCEMIA
1. Check blood glucose to
determine if hyperglycemia (high
blood glucose) is present.
2. Check urine for ketones as ordered
3. Treat according to care plan
and primary care provider's orders.
4. Recheck blood glucose as ordered
to monitor effectiveness of
5. Document findings and actions
taken to check for and treat hyper-
glycemia (high blood glucose).
Highs and Lows
LOW BLOOD GLUCOSE = HYPOGLYCEMIA
HYPOGLYCEMIA (LOW BLOOD GLUCOSE) is a MEDICAL EMERGENCY that must be addressed immediately!!
Even when people take good care of themselves, sometimes their blood sugar will drop below normal levels. Guidelines of what's considered a low blood glucose and how to treat it will be outlined in each student's doctor's orders and care plan, but generally speaking, a blood glucose below 70 mg/dl is considered low.
SYMPTOMS OF HYPOGLYCEMIA
1. Feeling shaky
2. Feeling hungry
4. Difficulty concentrating
5. Decreased level of
GUIDELINES TO TREATING HYPOGLYCEMIA
1. Check blood glucose to decide if hypo-
glycemia is present
2. If hypoglycemia (low blood sugar) is present,
follow instructions in orders to treat lows.
3. Recheck blood glucose in 15 minutes to see
if your treatment has been effective. If blood
glucose is still low, give another juice and
recheck again in 15 minutes to see if blood
glucose is back into the normal range.
4. Document findings and actions to correct the
low blood glucose.
The "Rule of 15/15 to treat Low Blood Glucoses" document in Google Docs gives general guidelines to treating low blood glucoses
Steps for checking urine for ketones
1. Keto-diastix or Ketostix (pictured)
2. Nonsterile gloves (if you are testing the
urine rather than the student)
3. Small cup to catch urine.
4. Something to measure time in seconds.
1. Put on non-sterile gloves (if assisting)
2. Give student the small cup and ask him/her to collect
a small amount of urine in the cup (a few drops will
3. Remove a Ketostix from the container
4. Dip the end of the stick with the colored pad in and then
out of the urine specimen.
5. Wait appropriate amount of time (15 to 60 seconds--
described on Ketostix bottle) and watch the colored pad
for changes in color.
6. Compare colored pad on end of stick with scale on side
of bottle at the appropriate time to determine whether or
not ketones are present.
7. If ketones are present, follow corrective action outlined in
student's medical orders and care plan.
8. Document results and actions taken.
When the body doesn't make enough insulin, medication (either in pill form or in injectable form) must be taken. Insulin is the medication most frequently given in children and adolescents with Diabetes. First, you must calculate how much insulin to give. Then, the student will take their insulin. There are several ways to give insulin; by an insulin pump, with an insulin pen, or with a syringe, drawing the insulin out of a glass vial. The next slides discuss calculating insulin doses and insulin administration using each of the three methods of giving insulin.
NOTE: Always double check your math when calculating insulin dosing. Most students can administer their own insulin. Always encourage students to do these procedures themselves whenever possible. If you assist, always wear nonsterile gloves and never recap needles. The only exception is when insulin is administered using an insulin pen. In this case, use either a mechanical device (such as a tweezer) to hold and replace the large, outer cap over the needle OR use a technique such as "swoop and scoop". This means scoop the outer cap back onto the needle, then use your fingers and one of the used cotton balls or gauze pads as you grasp the sides of the large, outer cap and lock it into place over the needle. Always wear nonsterile gloves any time you're assisting with a procedure that may expose you to blood.
Calculating Insulin Doses
ADMINISTERING INSULIN BY SYRINGE AND VIAL
Checking blood glucose (BG) levels allows students with Diabetes to monitor and better control their Diabetes. Students should check their BGs in the morning (right before breakfast), prior to meals, prior to physical activity, prior to bed and any time they are experiencing symptoms of either a high or low blood glucse (BG). The following video will walk you through the procedure step by step.
NOTE: Most students can independently perform this procedure. Always encourage students to do their own blood glucose checks whenever possible. IN THE EVENT YOU ASSIST: Always wear protective gloves any time you may be exposed to blood. To avoid pricking yourself with a used lancet, use either one of the cotton balls, gauze pads or a mechanical device such as a pair of tweezers to firmly grasp the sides of the lancet and gently pull to remove it from the lancet device. Dispose of the used lancet in a sharps container or, if on a field trip, in an empty plastic bottle until it can be disposed of in a sharps container.
Supplies needed to check blood glucoses:
1. A pair of nonsterile gloves (in the event you need to
2. Alcohol and two cotton balls or gauze pads OR
two alcohol wipes.
3. A lancet device
5. Test strips for the blood glucose monitor
6. A blood glucose monitor (glucometer)
7. A sharps container to put used lancets in
8. A mechanical device such as tweezers or small piers to
remove the lancet from the lancet device (optional)
19. A way to document your results
Insulin doses are calculated in two parts; part 1 takes into account how many carbohydrates the student is going to eat and part 2 corrects high blood glucose levels. Add the two numbers together, round to the nearest half or whole unit and you've got your total insulin dose! The following video will walk you through calculating insulin doses. Put your math thinking cap on or grab a calculator and let's go!!
Glucagon is used to treat extreme low blood glucoses in instances where a student is unable to safely drink, has passed out or is having a seizure caused by extremely low blood glucose levels. Any time glucagon is administered, 911 should be called to get additional medical support. The following video gives a good overview of how to prepare and administer glucagon and caring for someone who receives glucagon. Don't forget to document the event, your actions and results.
NOTE: Once glucagon is mixed and administered, dispose of syringe in an appropriate sharps container. IN ORDER TO PREVENT BEING STUCK BY A USED NEEDLE, NEVER RECAP THE NEEDLE ON THE GLUCAGON SYRINGE. Whenever possible, wear protective gloves when doing procedures that may expose you to blood.
DOCUMENT, DOCUMENT, DOCUMENT
Once you've decided what needs to be done and provided care, it's important that you document what you did, when you did it and who did it to create a record. The following Power Point goes over documentation guidelines and some tips to help you document with quality!
Let's see what you've learned!!
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The link below takes you directly to a quiz to see just what you've learned, or how good you are at finding the answers to your questions. It's an "open book" quiz, so don't be afraid to go back and look up anything you're not sure of. You must pass the quiz with a 90% or better to go on to the Simulation lab portion of the training. You will be notified of your results within one week of taking the quiz. READY? SET? CLICK ON THE LINK AND GO TO YOUR QUIZ! Good luck!!
Congratulations!!! You've finished Step 1
Go to PDExpress and schedule your simulation lab experience
Print off the supplemental resources attached to your initial email.
Safety is always our first priority
If you have questions, refer back to the Prezi
If you still have questions, find one of the district's registered nurses (RN's) and ask, ask, ask
You make a difference in the lives of these kids!!!!
ONE MORE STEP AND YOU'RE DONE!!!
TO PLAY THIS VIDEO... hover your cursor over the frame below. A play and a volume button will appear in the bottom left corner of the frame. Click on the arrow to play the video.