This case study discusses the medication routine for subcutaneous insulin, the use of NovoRapid insulin for type 1 diabetes, potential adverse effects, and nursing assessments. It also covers the daily physical and emotional challenges of living with type 1 diabetes.
Contribute Materials
Your contribution can guide someone’s learning journey. Share your
documents today.
401209 Health Variations 2 Assessment 2: Casestudy Assessment Questions Part A(60 marks, suggested 800 words) 1.Explain the 11 components of a valid routine subcutaneous insulin medication order and why this is important. Support your answer with academic or clinical guideline references. (5 marks) 172 The 11 components include- Understand the action and timing of the subcutaneous insulin medication. Understand the dose of the medication required for the particular patient. Identifythestandardadministrationtimesuchasbreakfast, lunch, dinner and pre-bed. Appropriate assemble of pen device. Chose proper length of the needle. Drawing up the subcutaneous insulin medication appropriately for syringe. Identify the proper site for injection. Note the expected frequency of BGL. Proper documentation of the medication Write the date and dose of medication, full trade or band name of insulin. Safediscardanddisposalofthemedicine (safetyandquality.gov.au, 2012). 1
Secure Best Marks with AI Grader
Need help grading? Try our AI Grader for instant feedback on your assignments.
It is important to follow the above components as it helps to avoid the medication error and administer the medication with proper meal such as breakfast, lunch and dinner could help to reduce the risk of hypoglycaemia. In addition the use of proper documentation and writing the brand name of medication could help to avoid confusion during medication thus could reduce the risk of adverse effect (Broderick & Coffey, 2013). 2.ExplainwhyBenhasbeenprescribedthismedication.Relateto pathophysiology of type 1 diabetes and the mechanism of action of NovoRapid insulin. Support your answer with academic references. (10 marks) 88 As mentioned in the case study Ben has been recommended to use NovoRapid for the treatment of type 1 diabetes. Because in case of such illness either the pan crease fails to produce adequate insulin or the body fails to utilise the insulin, thus, it becomes difficult to store or use glucose to generateenergy.Henceglucoseaccumulatesinbloodstream(Atkinson Eisenbarth & Michels, 2014). NovoRapid is a kind of subcutaneous insulin that helps to control the glucose spikes during mealtime and helps to utilise the glucose thus, reduce the blood glucose level (Rini et al., 2015). 3.What is the onset, peak and duration of action for NovoRapid insulin according toBullockandManias(2017)?ExplainwhenNovoRapidshouldbe administered in relation to food intake and why. Support your answer with academic references. (5 marks) 60 The onset of action of NovoRapid is 10 to 20 minutes, the peak of action is 40 to 50 minutes and duration of action is 3 to 5 hours.The medication should be administered before meal because as a person eat, the glucose level 2
increases and insulin could act to manage the glucose spikes and keep the glucose level normal (Bullock, & Manias, 2016). 4.Discuss the definition, causes, symptoms and treatment of hypoglycaemia, a common adverse effect of NovoRapid. Support your answer with academic references. (5 marks) 76 The condition in which blood glucose level reach below 72 mg/dl is considered as hypoglycaemia. The causes include high dose of medication suchasinsulin,overexercise,alcoholintakeanddelayintakingmeal. Symptoms include fatigue, sweating, rapid heart rate, pale skin, confusion, weakness, dizziness, blurred vision and come in severe case (Frier, 2014). It can be treated by fast acting glucose tablets or other sweets and juice. In severe case glucagon injection is used to treat hypoglycaemia (Ratner et al., 2013). 5.Discuss the importance of understanding the medication prior to administration. Support your answer with academic references. (5 marks) 57 Medication is used to treat illness and maintain well-being, however, somemedicationshaveadverseeffectthatcouldleadtodeteriorating condition.Besidetheeffectofmedivcationimproperadministrationof medication could leda to medication error. Thus it is important to understand the medication such as understand the dose, route, time, side effects and benefits before administer medication (Kim & Bates, 2013). 3
6.Discuss the 5 rights of medication administration and why it is important for nursestofollowthisprocedure.Supportyouranswerwithacademic references. (5 marks) 85 The 5 rights of medication administration include- Right patient Right drug Right dose Right route Right time (Bourbonnais & Caswell, 2014) It is important to follow the five rights of medication administration by a nurse as it helps to avoid medication error in an effective manner. Medication is provided to a patient to achieve desired health outcomes thus, it is important to follow the process of medication in order to maintain medication safety and eliminate adverse drug effect due to wrong administration of medication (Kim & Bates, 2013). 7.What is the most appropriate insulin pen needle length for Ben and why? Support your answer with academic references. (5 marks) 80 As the 19 years old Ben has been suffering from type 1 diabetes he has lost 10 kg of weight, thus it can be said that he has failed to maintain the normal body weight. Hence, the insulin pen needle length should be 4mm and skin fold may not require with this needle length. As Ben contains thin skin shorter length needle will help to maintain comfort level (adea.com.au, 2015). 8.Whatdiabetesspecificnursingassessmentwouldyouconductpriorto administration of NovoRapid insulin to Ben and why? Support your answer with academic references. (5 marks) 37 4
Paraphrase This Document
Need a fresh take? Get an instant paraphrase of this document with our AI Paraphraser
Prior to administer NovoRapid it is important to assess blood glucose level using glycated haemoglobin test, random blood sugar test and fasting blood sugar test to identify proper dose of medication and set the time of medication (American Diabetes Association, 2015). 9.Identify the site and angle you would inject the NovoRapid insulin and explain whythiswasselectedforBen.Discussinfectioncontrolconsiderations. Support your answer with academic references. (5 marks) 65 NovoRapid should be injected subcutaneously that is into the fat layer present between muscle and skin. As 4mm needle has been chosen for Ben, thus, it will be injected at 900angle (adea.com.au, 2015). In order to control the infection it is important to prepare the skin before injection, review the site of injection and identify lipohypertrophy and use evidence based techniques to prevent blood strem infection (Geerlings et al., 2014). 10.What would you document and where? Why is documentation important? Support your answer with academic or clinical guideline references. (5 marks) 59 In case of Ben it is important to document the blood glucose level before andaftermedicationanddocumentmedicationsuchasnameofthe medication,dose,typesuchasroutineorsupplementalandtime.The documentationneedtobedoneinAdministrationrecord (safetyandquality.gov.au, 2012). Such process would help to avoid medical 5
error and confusion thus, could ensure medication safety (Broderick & Coffey, 2013). 11.Explain the diabetes specific nursing assessment you would provide for Ben post administration of insulin, when you would provide it and why. Support your answer with academic references. (5 marks) 31 The post-administration assessment includes review the BGL to identify any improvement in the BGL or the requirement of practice change and modify the diabetes management plan to improve the patient’s condition (American Diabetes Association, 2015). Part B(10 marks, suggested 200 words) Discuss the potential impact of type 1 diabetes on Ben. 1.Discuss the daily physical challenges of living with type 1 diabetes that Ben may face.Support your answer with academic references. (5 marks) Living with type 1 diabetes is considered as challenging and stressful as well. In case of Ben the symptoms of type 1 diabetes such as increasing thirst and appetite, loss of weight, frequent urination could make it difficult for him to perform in the daily life activety. Due to such condition he could became tired during playing football as found in the case study. In addition he might be unable to attend his university regular basis (Atkinson Eisenbarth & Michels, 2014). In long-term chronic condition he could suffer from complications of 6
heart and kidney, nerve damage and severe eye and skin damage (Chiang et al., 2014). 2.Discuss potential emotional impacts of living with type 1 diabetes that Ben may face.Support your answer with academic references. (5 marks) Besidephysicalharmrestrictioninperformingdailyactivitiesthe chronic condition of type 1 diabetes impact on the mental health of the patient as well. As the management of diabetes is challenging, it could lead to the feelings of overwhelming. Thus, Ben could suffer from some uncomfortable emotion. The illness could reduce his ability to involve in the relationships. Change in behavior may occur such he could become stubborn (Atkinson Eisenbarth & Michels, 2014). Such condition could lead to depression and anxiety. Due to the stress of living with the illness he could become tired of struggling and it could lead to the suicidal thoughts as well (Chiang et al., 2014). 7
Secure Best Marks with AI Grader
Need help grading? Try our AI Grader for instant feedback on your assignments.
Reference list adea.com.au (2015). Australian Diabetes Educators Association (ADEA). Clinical GuidingPrinciplesforSubcutaneousInjectionTechnique.Canberra. Retrievedfrom https://www.adea.com.au/wp-content/uploads/2015/11/Injection-Technique- Final-digital-version2.pdf American Diabetes Association. (2015). Standards of medical care in diabetes— 2015 abridged for primary care providers.Clinical diabetes: a publication of the American Diabetes Association,33(2), 97. doi:10.2337/diaclin.33.2.97 Atkinson, M. A., Eisenbarth, G. S., & Michels, A. W. (2014). Type 1 diabetes.The Lancet,383(9911), 69-82. https://doi.org/10.1016/S0140-6736(13)60591-7 Bourbonnais,F.F.,&Caswell,W.(2014).Teachingsuccessfulmedication administration today: More than just knowing your ‘rights’.Nurse education in practice,14(4), 391-395. https://doi.org/10.1016/j.nepr.2014.03.003 Broderick,M.C.,&Coffey,A.(2013).Person‐centredcareinnursing documentation.International journal of older people nursing,8(4), 309-318. doi/abs/10.1111/opn.12012 Bullock, A., & Manias, E. (2016). Fundamentals of pharmacology. Retrieved from http://ebookcentral.proquest.com Chiang, J. L., Kirkman, M. S., Laffel, L. M., & Peters, A. L. (2014). Type 1 diabetes throughthelifespan:apositionstatementoftheAmericanDiabetes Association.Diabetescare,37(7),2034-2054.https://doi.org/10.2337/dc14- 1140 8
Frier, B. M. (2014). Hypoglycaemia in diabetes mellitus: epidemiology and clinical implications.NatureReviewsEndocrinology,10(12),711.Retrievedfrom https://www.nature.com/articles/nrendo.2014.170 Geerlings, S., Fonseca, V., Castro-Diaz, D., List, J., & Parikh, S. (2014). Genital and urinarytractinfectionsindiabetes:impactofpharmacologically-induced glucosuria.Diabetesresearchandclinicalpractice,103(3),373-381. https://doi.org/10.1016/j.diabres.2013.12.052 Kim,J.,&Bates,D.W.(2013).Medicationadministrationerrorsbynurses: adherencetoguidelines.JournalofClinicalNursing,22(3-4),590-598. doi/abs/10.1111/j.1365-2702.2012.04344.x Ratner, R. E., Gough, S. C. L., Mathieu, C., Del Prato, S., Bode, B., Mersebach, H.,...&Zinman,B.(2013).Hypoglycaemiariskwithinsulindegludec compared with insulin glargine in type 2 and type 1 diabetes: a pre‐planned meta‐analysis of phase 3 trials.Diabetes, Obesity and Metabolism,15(2), 175-184. doi/abs/10.1111/dom.12032 Rini, C. J., McVey, E., Sutter, D., Keith, S., Kurth, H. J., Nosek, L., ... & Pettis, R. J. (2015).Intradermalinsulininfusionachievesfasterinsulinactionthan subcutaneousinfusionfor3-daywear.Drugdeliveryandtranslational research,5(4), 332-345. Doi: 10.1007/s13346-015-0239-x safetyandquality.gov.au (2012). Australian Commission on Safety and Quality in Health Care User Guide to National Insulin Subcutaneous Order and Blood GlucoseRecord:Adult,ACSQHC,Sydney.Retrievedfrom https://safetyandquality.gov.au/wp-content/uploads/2012/06/National- Subcutaneous-Insulin-Pilot-Project-Insulin-Form-User-Guide.pdf 9