Health Variations: Subcutaneous Insulin Medication Order and NovoRapid Insulin Administration

This article discusses the eleven components of a valid routine subcutaneous insulin medication order, appropriate administration of NovoRapid insulin, and the challenges of living with type 1 diabetes. It emphasizes the importance of medication safety and understanding medication before administration. The article also highlights the five rights of medication administration and the nursing assessments required before and after administration.

Running head: HEALTH VARIATIONS
HEALTH VARIATIONS
Name of the Student:
Name of the University:
Author Note:

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HEALTH VARIATIONS
Part A
1.
The eleven components of the valid routine subcutaneous insulin medication
order includes the purpose of the order, followed by the general instructions regarding
the order. The next component is the identification and the demographics of the
patient and the involved hospitals. This is followed by monitoring of the blood
glucose level frequency and the notification to the medical officer in such cases. The
next component is the monitoring record of the blood glucose levels. This is followed
by insulin orders and the documentation of the insulin administration. The next
component of the order is the comment section which is followed by guidelines for
managing hyperglycaemia alerts. The next component is the hypoglycaemia
management in diabetes for the adults and finally there is a pharmacy review (Wong
et al., 2016).
This is important as the supplemental insulin orders have been aligned with the
BGL monitoring area of the new order. Additionally the routine insulin is seen to be
aligned with the daily BGL monitoring and insulin administration areas.
2.
NovoRapid insulin is prescribed to patients with type 1 diabetes since it includes
all the active ingredients of insulin. Individuals with diabetes lack or have a
deficiency of the hormone insulin which is secreted by the pancreas. Insulin is the
main hormone that responsible for the controlling of sugar level in the blood.
Therefore people with diabetes have to be injected with insulin externally to control
their glucose level in the blood. NovoRapid is a fast acting insulin that is injected

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under the skin to lower the blood glucose level. This takes about 10 to 20 minutes to
work (Bowering et al., 2017).
3.
According to Bullock and Manias (2017) the onset is 10 to 30 minutes, the peak is
for 30 minutes to 3 hours and the duration is for 3 to 5 hours. The NovoRapid insulin
should be administered immediately prior to having food because of the rapid onset of
action. This be before the start of the meal and should not exceed more than 5-10
minutes after injection. However sometimes if necessary it can be soon after the meal,
instead of before the meal (Bullock& Manias, 2013).
4.
Hypoglycaemia is referred to the condition which occurs when the blood
glucose level falls below a set point that might be 4 mmol/L. The symptoms include
sweating along with fatigue and dizziness. Other symptoms might include feeling
hungry, blurred vision and sometimes in extreme case it might lead to coma. The
causes of the disease include high dosage of medication like insulin along with
delayed meals. Often exercise and alcohol also might cause the disease. Treatment
involves eating along with drinking a amount of 15-20g of carbohydrate which is fast
acting such as glucose tablets or sweets, sugary fizzy drinks or fruit juice (Frier,
2014).
5.
It is important to understand the medication before administration in order to
ensure that there is no medication error. This is because medication errors are the
most significant errors in health care, which challenges the patient safety.
Administration of medication requires good decision making skills. In order to do so

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understanding the medication is required so that a clinical judgement can be made
(Keers, Williams, Cooke& Ashcroft, 2013).
6.
The five rights of medication administration involves the right patient, the
right drug, the right route followed by right dose and the right time. This is important
to be followed by the nurses as this helps to reduce medication errors that takes place
during the administration of a medication. If the five rights are maintained as goals in
the process of medication then medication safety will be ensured (Dolansky,
Druschel, Helba& Courtney, 2013).
7.
For the patient Ben, the appropriate needle size for insulin injection would be
4mm (Hirsch, Byron&Gibney, 2014).
8.
Before administration of NovoRapid the following nursing assessments are
needed to be conducted. This includes the consideration that whether the patient’s
insulin is available in the vials or the prefilled devices. The dose required for the
patient is needed to be checked from the patient’s prescription chart. Before the
administration the expiry date needs to be checked. Before administration the blood
glucose level needs to be checked. The injection site also needs to be determined (Frid
et al., 2016) .
9.
This Novarapid is generally injected under the skin and at a 90 degree angle in
order to get the best penetration. The site is slightly pinched before applying the
injection and the plunger is pressed until the dial goes back to 0.For prevention of
infection during insulin administration, the following steps might be taken: avoiding

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Fingerstick devices to be applied to more than one patient. The blood glucose meters
should not be shared with others. The insulin pens along with medication cartridges
and the syringes should be used only for single-patient-use and not for more than one
person (Smith et al., 2017).
10.
Documentation is required before and after administration in order to prevent
medication error. The documentation provides records to the doses that the patient has
been administered with (Nicolucci et al., 2013).
11.
After the administration of the drug, the blood glucose level again needs to be
monitored. The nurses will be responsible for the safe disposal of the syringe after the
administration. The nurses will be responsible for recording the insulin taken along
with your blood glucose levels (Young-Hyman et al., 2016).
Part 2
1.
Living with diabetes type 1 has several challenges like lifestyle changes which
involves diet modification along with blood glucose monitoring needed on a regular
basis. There is a need for carbohydrate counting along with very regular
administration. The challenges also include the implementation of self-management
skills (Nicolucci et al., 2013).
2.
Presence of diabetes increases stress and distress in patients especially in the
younger adults. They undergo various emotional problems along with psychological
changes, depression being the most prevalent among all the other symptoms. This

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leads to negative disease outcomes and poor functioning of the overall health
functioning (Young-Hyman et al., 2016).
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