MEDICAL MANAGEMENT

A. DIAGNOSTIC AND LABORATORY PROCEDURES

Diagnostic and General Indications or Normal Analysis and

Laboratory Description Purposes Values Interpretation
Procedures

The A1C test— It’s one of the Diagnosing An A1C level

also known as the commonly used Prediabetes below 5.7% is
A1C TEST hemoglobin A1C tests to diagnose or Diabetes considered within
or HbA1c test—is prediabetes and the normal range,
a simple blood diabetes, and is Normal: while a range
test that measures also the main Below 5.7 % between 5.7% and
your average test to help you 6.4% suggests
blood sugar levels and your health Prediabetes: prediabetes,
over the past 3 care team 5.7% to 6.4% indicating a higher
months. manage your risk of developing
diabetes. Higher Diabetes: type 2 diabetes. A
A1C levels are 6.5% or above level of 6.5% or
linked to higher indicates
diabetes diabetes. It's
complications, important to note
so reaching and that within the
maintaining prediabetes range
your individual of 5.7% to 6.4%,
A1C goal is the risk of
really important progressing to type
if you have 2 diabetes increases
diabetes. with higher A1C
levels. Therefore,
individuals with
A1C levels at the
higher end of this
range should be
especially vigilant
about managing
their blood sugar
levels and adopting
lifestyle changes to
reduce their risk of
developing
diabetes.

NURSING CONSIDERATION:
 Educate patients on the test's purpose and importance.
 Ensure patient compliance with pre-test instructions.
 Use proper blood collection techniques for accurate results..
 Communicate effectively about result interpretation and implications.
 Document all aspects of the test procedure accurately.
  Monitor for signs of infection during blood collection.
 Encourage adherence to follow-up care and treatment plans.
 Address patient concerns and provide additional resources as needed.
 Collaborate with the healthcare team for comprehensive diabetes management.
https://www.cdc.gov/diabetes/managing/managing-blood-sugar/a1c.html

Diagnostic and General Indications or Normal Analysis and

Laboratory Description Purposes Values Interpretation
Procedures

The fasting blood Fasting blood The results of If the patient has a
FASTING sugar test, also sugar (FBS) the fasting high fasting blood
BLOOD known as the measures blood blood sugar sugar level, the
SUAGR TEST fasting plasma glucose after test will come healthcare provider
glucose (FPG) you have not back as a may repeat the test
test, is a eaten for at least number: to make sure. If the
diagnostic test 8 hours. It is test reveals that
used to measure often the first - 99 mg/dL or patient have
the concentration test done to lower: This is prediabetes, the
of glucose (sugar) check for a normal healthcare provider
in the bloodstream prediabetes and fasting blood will recommend
after a period of diabetes. sugar level. you repeat the
fasting. It involves fasting blood sugar
collecting a blood - 100–125 test every year or
sample from the mg/dL: two. The results
patient after they Fasting blood will help you know
have abstained sugar in this whether you are
from consuming range typically progressing to Type
any food or indicates 2 diabetes.
beverages (except prediabetes.
water) for at least This means
8 hours, typically your blood
overnight. sugar levels
are higher than
normal but not
high enough to
be classified as
diabetes.

- 126 mg/dL or
above: This
indicates high
blood sugar,
the main sign
of diabetes.
NURSING CONSIDERATION:
 Educate patients on fasting requirements.
 Verify fasting status before testing.
 Ensure proper blood collection techniques.
 Provide comfort and support during the procedure.
 Monitor for adverse reactions.
 Communicate effectively with the healthcare team.
 Provide post-test education and follow-up.

American Diabetes Association. Diagnosis (https://www.diabetes.org/a1c/diagnosis) .

Accessed 11/9/2021.
Centers for Disease Control and Prevention. Diabetes Tests
(https://www.cdc.gov/diabetes/basics/getting-tested.html). Accessed 11/9/2021.
Centers for Disease Control and Prevention. Insulin Resistance and Diabetes
(https://www.cdc.gov/diabetes/basics/insulin-resistance.html). Accessed 11/9/2021.
Diagnostic and General Indications or Normal Analysis and
Laboratory Description Purposes Values Interpretation
Procedures

Random blood Random blood This measures The random blood

RANDOM sugar (RBS) sugar test can your blood sugar test provides
BLOOD measures blood help you sugar at the a snapshot of blood
SUGAR TEST glucose regardless identify time you’re glucose levels at
of when you last hyperglycemia tested. You any given time,
ate. Several and decrease the can take this regardless of the
random risk for some test at any time timing of the last
measurements chronic and don’t need meal. A normal
may be taken complications. to fast (not eat) random blood sugar
throughout the Testing your first. A blood level typically falls
day. Random blood glucose sugar level of below 200 mg/dL
testing is useful levels at various 200 mg/dL or (11.1 mmol/L).
because glucose times higher Elevated levels,
levels in healthy throughout the indicates you especially above
people do not vary day can help have diabetes. 200 mg/dL (11.1
widely throughout you manage mmol/L), may
the day. Blood your diabetes suggest diabetes
glucose levels that and reduce your mellitus,
vary widely may risk of diabetes particularly when
mean a problem. complications. accompanied by
This test is also symptoms such as
called a casual frequent urination,
blood glucose test. excessive thirst,
and unexplained
weight loss. For
individuals with
known diabetes,
high random blood
sugar levels may
indicate poor
glycemic control
and the need for
adjustments to
treatment.

NURSING CONSIDERATION:

 Review the patient’s medical history for diabetes type, medications, and/or
anticoagulant therapy.
 Determine if the test requires special timing; for example, before or after meals.
Blood glucose monitoring is usually done prior to meals and the administration of
anti diabetic medications.
 Determine if blood glucose meter needs to be calibrated.
 Assess patient’s sites for skin puncture.
 Document the test result.
https://opentextbc.ca/clinicalskills/chapter/8-2-glucometer-use/
https://www.cdc.gov/diabetes/basics/getting-tested.html#:~:text=Random%20Blood
%20Sugar%20Test,higher%20indicates%20you%20have%20diabetes.
https://www.medicalnewstoday.com/articles/7504

LEARNING DERIVED
As a student nurse, encountering diabetes mellitus cases has been integral to my
clinical education. Diabetes mellitus, characterized by elevated blood sugar levels,
presents multifaceted challenges requiring diligent monitoring and comprehensive
care. During my clinical rotations, I've assisted in assessing patients' blood glucose
levels, administering insulin and oral medications, and providing education on
lifestyle modifications. These experiences have deepened my understanding of
diabetes management, emphasizing the importance of patient education, medication
adherence, and regular monitoring. Through collaboration with healthcare teams, I've
learned to approach diabetes care holistically, addressing not only the physical aspects
but also the psychosocial and emotional needs of patients. My involvement in
diabetes care as a student nurse has prepared me to deliver compassionate, evidence-
based care to individuals living with this chronic condition.