I have a new client with effective use of only one hand. (The other being curled up and numb from a stroke 30 years ago.) She’s orally controlled, no insulin, but her doctor would like a glucose check once a day. Other nurses have tried and failed to teach her how to do accuchecks, so now it’s my turn.
I was wondering if this new(er) alternate site testing might be easier for her, but I don’t know much about it. Anything you can tell me before I pursue this notion with her doctor?
(And yes, I’ve requested an OT consult, but that won’t happen until next week, whatwith the holiday and all…)
Why can’t she still test on her other hand? It has the same blood as the rest of her body, and the numbness would actually be an advantage (sometimes it’s a little painful).
Her fingertips are curled into her palm and her whole hand curls into her forearm at the wrist. With effort, she can use her left hand to open her right hand, but as soon as she lets go (like to pick up a lancet), the fingertips disappear again.
It looks like the big issue with alternate test sites is that they lag behind the whole-body blood sugar level. Since she’s only testing once a day, to establish a baseline, so long as she tests at a consistent time of day (relative to her last meal), it should work out okay.
It also sounds like the circumstances that would require her to test via finger-stick are time-sensitive enough that, if she feels she’s running low, she should eat something, then work through the rigamarole of testing via fingers or palm of her hand. Since she can, with difficulty, force her hand open, would she be able to force it to grab, say, a soda can? That would leave the hand opened enough that she should be able to test in a finger. It’s also not outside the bounds of reason that, with enough practice, she could do the finger-stick one-handed, with her left hand.