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SelfAdministrationAssessmentUsingaGlucometer NameofIndividual: DateofBirth: Setting(s)of assessment(home, work, recreation, etc.): Thisassessmentistobecompletedbyapersonwhoknowstheindividualwell,
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01
Wash your hands thoroughly before starting the process.
02
Gather all the necessary supplies such as a clean syringe, the prescribed medication, a cup of water, and a clean cloth.
03
Open the medication packaging and draw the correct dosage of the medication into the syringe.
04
Connect the syringe to the gj tube by inserting it gently into the designated port.
05
Slowly push the plunger of the syringe to administer the medication into the tube.
06
Flush the tube with water as instructed by your healthcare provider.
07
Use a clean cloth to clean the gj tube port and the surrounding area.
08
Store the medication and supplies in a safe and clean place.
09
Follow any additional instructions provided by your healthcare provider or caregiver.

Who needs self-administration assessment gj tube?

01
Individuals who have a gj tube and are capable of self-administering medication through the tube.
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Self-administration assessment gj tube is a form used to assess a patient's ability to independently manage their gastrojejunal (GJ) tube.
Patients who have a gastrojejunal (GJ) tube are required to file the self-administration assessment.
To fill out the self-administration assessment gj tube, the patient or their caregiver must answer questions about their ability to independently care for the GJ tube.
The purpose of the self-administration assessment gj tube is to determine the patient's ability to safely manage their GJ tube.
Information such as tube care procedures, signs of complications, and emergency response plans must be reported on the self-administration assessment gj tube.
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