Supplies: Gloves, glucometer, lancet, glucose test strips, alcohol swab, cotton ball or gauze

General Instructions:

1. Wash or gel hands, gather supplies
2. Check the expiration date on the test strips and ensure that the glucometer does not need a quality control test
3. Identify the patient and explain the procedure
4. Wash your hands and don gloves
5. Request that the patient washes their hands, if possible
6. Turn on the glucometer and insert the test strip
7. Clean the patient's preferred finger with an alcohol swab (if they were unable to wash their hands), let air dry completely
8. Use the lancet on the side of the finger pad (you may gently squeeze the finger to express blood)
9. Touch the drop of blood to the test strip
10. Give the patient a cotton ball or gauze for the finger
11. Document results of the blood glucose level in the medical record

Tips & Tricks:

• A puncture on the side of the finger near the tip is less painful and has better blood flow
• If the patient's hand is cold, have them run their hand under warm water and hold their hand in a dependent position while puncturing

Additional Information/Instruction:

Step-by-step instructions and more information about blood glucose testing: https://www.ebscohost.com/assets-sample-content/NRC_Blood-Glucose-Testing-at-the-Bedside-NPS.pdf

Video: https://www.youtube.com/watch?v=28oRB1LWWEw

More information from the CDC about safe blood glucose monitoring: https://www.cdc.gov/injectionsafety/blood-glucose-monitoring.html

*The above information was derived from the Core Curriculum for Ambulatory Care Nursing, 4th edition, by Candia Laughlin & Stephanie Witwer. Used with permission of AAACN. Find more information at https://www.aaacn.org/

Supplies: Gloves, reagent kit, lint-free tissue, lancet, alcohol swab, cotton swab or gauze

General Instructions:

1. Wash or gel hands, gather supplies
2. Ensure that quality control test has been completed on machine (for step-by-step instructions on quality control tests, see pg. 87 of the operator's guide) and check expiration date of reagent kit
3. Wash your hands and don gloves
4. Open the reagent cartridge foil package, remove plastic from the capillary holder (for pictures of these items and more detailed step-by-step instructions, refer to pages 48-55 of the operator's guide)
5. Clean the patient's preferred finger with an alcohol swab (or ask them to wash their hands with soap and water), let finger air dry completely
6. Use the lancet on the side of the finger pad (you may gently squeeze the finger to express blood)
7. Touch the tip of the capillary holder to the drop of blood
8. Use the tissue to carefully wipe the outside of the capillary holder (do not touch the tissue to the end of the holder; this may wick the blood out of the holder and result in loss of the specimen)
9. Insert the capillary holder into the reagent cartridge until it snaps into place (see page 53 of the operator's guide for a picture of this step)
10. Scan the reagent cartridge by inserting the cartridge into the barcode track and smoothly sliding it down until you hear a beep (if you do not hear a beep, scan again)
11. Follow the promptings on the screen
12. Open the cartridge compartment door (located below the digital screen) and insert the reagent cartridge until you hear or feel a click
13. Gently remove the flexible pull-tab from the reagent cartridge and close the cartridge compartment door
14. Five seconds after closing the door, a beep will indicate that the test has begun (results should be available in 6 minutes)
15. Document results in the patient's medical record

Tips & Tricks:

• Hold the capillary holder at an angle when obtaining a blood sample from the patient

Additional Information/Instruction:

Video for Siemen's HgbA1C machine: https://www.youtube.com/watch?v=lMuGnj4TtyM

Operator's guide: https://www.stat-technologies.com/wp-content/uploads/2018/12/DCA-Vantage-Operators-Guide.pdf

*The above instructions were derived from the Siemen's Operator guide found at https://www.stat-technologies.com/wp-content/uploads/2018/12/DCA-Vantage-Operators-Guide.pdf

Supplies: Gloves, flu swab packet

General instructions:

1. Wash your hands
2. Read the instructions on the flu swab package
3. Explain the procedure to the patient
4. Ask the patient to blow their nose
5. Don gloves
6. Remove the swab from the package and hold it with your dominant hand
7. Support the patient's head with your non-dominant hand and have the patient tilt their head back
8. Gently insert the swab into the nasal passage until you meet resistance
9. Rotate the swab for approximately 10 seconds
10. Remove the swab and follow the package's instructions for testing the specimen
11. Document results in the patient's medical record

Additional Information/Instruction:

Instructional video: https://www.youtube.com/watch?v=DVJNWefmHjE

Information from the CDC about Influenza: https://www.cdc.gov/flu/professionals/diagnosis/labrolesprocedures.htm

Supplies: Gloves, tongue depressor, flashlight or penlight, rapid strep test swab and reagent that are available, and timer

General instructions:

1. Wash your hands or gel, gather supplies
2. Read the instructions on the rapid strep swab package and check the expiration date on all materials
3. Identify patient and explain the procedure
4. Wash hands and don gloves
5. Ask the patient to tilt their head back and check the back of the throat using the tongue depressor and penlight, then instruct the patient to relax
6. Remove the swab (culturette) from the package and hold it with your dominant hand
7. Ask the patient to stick out their tongue and tilt their head back slightly, use tongue depressor with non-dominant hand
8. Gently and quickly insert the swab into the mouth and rub the end on both tonsils, using a side to side motion
9. Remove the swab and follow the package's instructions for testing the specimen
10. Start the timer (typically results are read in 5 minutes)
11. Document results in the patient's medical record

Tips & Tricks:

• Avoid touching tongue with swab

Additional Information/Instruction:

Instructional video: https://www.youtube.com/watch?v=-uyBJ0nv4oI

*The above information was derived from the Core Curriculum for Ambulatory Care Nursing, 4th edition, by Candia Laughlin & Stephanie Witwer. Used with permission of AAACN. Find more information at https://www.aaacn.org/

Supplies: Peak flow meter

General instructions:

1. Wash your hands, gather supplies
2. Explain procedure to patient
3. Move the marker/arrows to the bottom of the peak flow meter number scale
4. Instruct the patient to stand up straight, take a full breath in, place their lips tightly over the mouth piece, and blow into the peak flow meter as hard and fast as they can
5. Note the number where the marker/arrow advanced to and document these results in the patient's medical record

Tips & Tricks:

• Ask the patient to stand up straight while using the peak flow meter
• Tell the patient to pretend they are blowing out birthday candles as hard and fast as they can when using the peak flow meter

Additional Information/Instruction:

Instructional video: https://www.youtube.com/watch?v=6oKupWgDu80

Information on Peak Flow Meters from Mayo Clinic: https://www.mayoclinic.org/tests-procedures/peak-flow-meter/about/pac-20394858

*The above instructions were derived from the American Lung Association's youtube video titled "How to use a peak flow meter." found at https://www.youtube.com/watch?v=6oKupWgDu80

Supplies: Gloves, urine specimen container, label, patient wipes, timer, urinalysis, reagent strips, paper towel

General instructions:

1. Gather supplies and check expiration date of test strips
2. Wash your hands, don gloves
3. Set out paper towel and prepare a stopwatch
4. Gently mix the urine well prior to testing
5. Remove test strip from the bottle and fully submerge it in the urine for several seconds
6. Allow excess urine to drip off the test strip and lay it face-up on the paper towel
7. Start the stopwatch
8. Compare each colored box on the urine strip to the appropriate section on the test strip bottle (wait the appropriate amount of time for each section; this should be indicated on the bottle)
9. Discard the used strip and urine
10. Sanitize the test strip bottle and your working surface
11. Document the results in the patient's medical record, also noting the specimen color, clarity, and odor

Tips & Tricks:

• If there is not enough urine to submerge the strip, you can use a dropper and drop urine on each test strip block

Additional Information/Instruction:

Instructional video: https://www.youtube.com/watch?v=uxBCLb5cQpc

*The above information was derived from the Core Curriculum for Ambulatory Care Nursing, 4th edition, by Candia Laughlin & Stephanie Witwer. Used with permission of AAACN. Find more information at https://www.aaacn.org/

Supplies: Gloves, urine specimen container, urine hCG kit, dropper, timer

General instructions:

1. Gather supplies and check expiration date of hCG kit
2. Wash your hands, don gloves
3. Gently mix the urine well prior to testing
4. Open the test and place the test device on a level, clean surface
5. Follow manufacturer's instructions on testing procedure and timing
6. Hold dropper vertically and transfer three full drops of urine to sample well of test device and start timer
7. Wait the amount of time indicated by the manufacturer
8. Read test and control lines according to manufacturer's instructions
9. Document results in the patient's medical record

Tips & Tricks:

• First morning urine sample is preferred because it contains the highest concentration of hCG

*The above information was derived from the Core Curriculum for Ambulatory Care Nursing, 4th edition, by Candia Laughlin & Stephanie Witwer. Used with permission of AAACN. Find more information at https://www.aaacn.org/