Monitoring and Documentation Flashcards

A resident refuses to have their blood glucose checked before insulin administration. The QMA should:

Answer: Respect the refusal, document it, and notify the nurse

Residents have the right to refuse; the QMA must document the refusal and notify the nurse so a clinical decision can be made.

Which documentation entry is written correctly for a blood glucose check?

Answer: Blood glucose 142 mg/dL at 0730, insulin administered per sliding scale

Complete documentation includes the specific value, time, and action taken, avoiding vague or subjective language.

A QMA makes a documentation error in the paper medication record. The correct procedure is to:

Answer: Draw a single line through the error, initial it, and write the correct entry

A single line through the error with initials maintains a legal record while correcting the mistake; correction fluid destroys the record's legal integrity.

After administering insulin, the QMA should monitor the resident for signs of hypoglycemia for at least:

Answer: 30–60 minutes

Insulin onset varies by type, but monitoring for hypoglycemia for 30–60 minutes post-administration captures most early reactions.

A blood glucose meter displays 'HI' instead of a number. This MOST likely means:

Answer: The blood glucose exceeds the meter's measurement range (usually >600 mg/dL)

'HI' on a glucometer indicates the blood glucose is above the meter's upper detection limit, signaling severe hyperglycemia requiring immediate nurse notification.

Which of the following BEST describes the purpose of a sliding scale insulin protocol in documentation?

Answer: It provides a pre-ordered dosing guide based on specific blood glucose ranges

A sliding scale is a physician-ordered protocol that matches insulin doses to specific blood glucose readings to maintain glycemic control.

If a resident's blood glucose is 400 mg/dL and the sliding scale ends at 350 mg/dL, the QMA should:

Answer: Notify the nurse immediately, as the reading is outside the protocol range

A reading outside the sliding scale range requires nurse notification; the QMA cannot independently extrapolate dosing beyond the ordered protocol.