Assessment 2 Case Study on NovoRapid Insulin for Type 1 Diabetes
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Added on 2023/06/07
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This case study discusses the use of NovoRapid insulin for type 1 diabetes, including dosage, administration, and potential side effects. It also covers the psychological impact of diabetes and the importance of emotional support.
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Running Head: ASSESSMENT 2 CASE STUDY Assessment 2 case study Student’s Name Institution Date
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ASSESSMENT 2 CASE STUDY2 Part A Question 1 Firstly, the nurse will need to Ben’s name in full and the date he received the insulin dose. The nurse will also specify the insulin name (NovoRapid insulin) and the dosage. The time and frequency of medication administration should also appear in the medication order. In addition, Ben’s residence and his contact information should be indicated. Lastly, the nurse should write his or her name. All these components, according to Rossetti, Porcellati, Bolli & Fanelli (2008) enhance Ben’s safety. Question 2 Ben was prescribed NovoRapid because his beta cells cannot synthesize enough insulin and hence his system needs to be supplemented with artificial insulin that can perform similar function as normal insulin. Novorapid is almost similar to the insulin released by the pancreas of a person without diabetes (Goldman-Levine & Lee, 2005). They begin to be active 10-15 minutes after being punctured. Its activity peak is at 30-90 minutes and last between 3 and 4 hours. Question 3 Novorapid insulin has a shorter duration of action compared to human soluble insulin after subcutaneous injection. According to Bullock & Manias (2017), NovoRapid begin to be active 10-15 minutes after being punctured. Its activity peak is at 30-90 minutes and last between 3 and 4 hours. NovoRapid ® has a faster onset of action and a shorter duration than soluble human insulin. Because of the faster onset of action, NovoRapid ® should usually be administered immediately before a meal (Rossetti, Porcellati, Bolli & Fanelli, 2008).
ASSESSMENT 2 CASE STUDY3 Question 4 Hypoglycemia in an adult is defined as a blood glucose level below 40 mg / dl, even in the absence of symptoms (Skyler, 2004). It is caused by inadequate intake of glucose or food rich in glucose. The common symptoms include sweating, palpitations, anxiety, changes in the pupillary size and increase in the secretion of saliva by the parotid. Hypoglycemia is treated by intravenous administration of glucose. It is not advisable to administer NovoRapid to hypoglycemic individuals because NovoRapid increase the uptake of blood glucose yet hypoglycemic patients have low level of blood glucose. Question 5 Since Ben is suffering from type 1 diabetes, it is important to choose medication whose pharmacodynamic properties fit’s Ben’s condition. Ben needs medication that act first. Different medications have different pharmacodynamic properties (Goldman-Levine & Lee, 2005). These properties dictate the time, dosage and frequency. For example, NovoRapid ® produces a faster onset of action compared and hence stands out as the best replacement for insulin deficiency (Florence, 2015). The replacement insulin acts in the same way as naturally produced insulin and helps glucose to enter the blood in the cells (Bullock & Manias, 2013). Question 6 The first right is the right patient, for our case, Ben is the right patient. The second right is right drug, for this case, NovoRapid. The third right is right of medication. Right of medication describes the right for Ben to be treated. Another right is the right route. For Ben’s case, the right route is subcutaneous route because NovoRapid can be absorbed immediately into blood vessels
ASSESSMENT 2 CASE STUDY4 located in subcutaneous layer. Lastly, the right dose is another key right of medication (Fogarty & McKeon 2006). Question 7 Needles of 5 and 6 mm in length for an insulin pen or injector are recommended for Ben. This is because Ben can be categorized as an adult patient with reduced body weight or for standard injection into a reduced layer of subcutaneous tissue (Gibney, Arce, Byron & Hirsch 2010). The needles of 5 to 6 mm will ensure that the insulin is delivered to the right point where it can get into blood stream as soon as possible. Question 8 Some of the assessment to conduct before administering insulin is to determine whether Ben could be having other illness. If it is determined that Ben have another condition, then nurse will have to evaluate the effectiveness of medication and determine the right dosage (Wallace & Matthews 2004). In addition, nurse will have to assess whether Ben is agitated or stressed, whether he is taking various medications, and his level of physical activity. These assessments will enable nurses choose the best medication and determine the right dosage. Question 9 The recommended injection sites for Ben is the anterior wall of the abdomen and the external surface of the thigh. The angle of the injection should be 45 °, and a skin fold should be formed (Gibney, Arce, Byron & Hirsch 2010). Pathogens can enter through the broken skin. Hence it is advisable to use sterilize cotton, sterilized needle and remove the needle in the angle at which it penetrated the injection site in order to avoid infections (Gibney, Arce, Byron & Hirsch 2010).
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ASSESSMENT 2 CASE STUDY5 Question 10 The first thing to document is the name of medication. Based on the diagnosis made, Ben should receive NovoRapid insulin, medication designed to address insulin deficiency (Masse, et al 2018).. NovoRapid is an insulin replacement that is very close to insulin produced by the body. The second thing to document is the amount of dose given (In Qureshi & In Maxwell, 2014). The usual dose is between 0.5 and 1.0 units per kilogram of body weight per day. The third thing to document is route used and site for injection. NovoRapid is given by subcutaneous injection into the abdominal wall, thighs, arms, shoulder or shoulder. Other aspects to document include time administered, initials and signature. Documentationshelp in ensuring ongoing care is done efficiently (Aitken, Manias & Dunning 2006). Question 11 One of the post administration assessment is to determine potential side effects. Improper dosing, in most cases, may lead to hyperglycaemia and diabetic ketoacidosis. Ketoacidosis does not occur immediately (George, Byun & Howard-Thompson, 2018). The first symptoms develop slowly over hours or days. Consequently, it is a role of nurse to follow up and assess the effects of every drug administered so as to intervene accordingly in case of contraindication. It is also important to note that the NovoRapid may cause hypoglycaemia (low blood sugar). The nurse should therefore be ready to assess Ben in order to determine whether he developed hypoglycemia or hyperglycemia (Skyler, 2004). Part 2 Question 1
ASSESSMENT 2 CASE STUDY6 Firstly, it is important to note that the common symptoms of type 1 diabetes include constant thirst, frequent urge to urinate, weakness and drowsiness, blurred vision, sensation of goosebumps, numbness and tingling in the palms and soles, skin problems, poorly healing cuts and scratches, sudden weight loss and severe hunger with proper and full nutrition (Brazeau, Rabasa-Lhoret & Strychar et al. (2008). These symptoms may make it inconvenient for Ben to engage in daily activities. If Ben used to go out the whole day, he will have to change his behavior and schedule. In other words, diabetes type 1 will force Ben to live relatively restricted lifestyle. Question 2 Diabetes mellitus is a physical illness, but it puts our psychological world in check. After the diagnosis can appear compatible pictures with: anxiety, social withdrawal, depression, anger, feelings of guilt and disability and a series of feelings and situations that can worsen the general state of mind of the patient (Wallace & Matthews 2004). Ben has a risk of social isolation or emotional disorders that affect their more social sphere, so it is important to address these aspects. This is why psychologists stress the importance of taking care of internal emotional world by supporting our loved ones, going to group therapy with people suffering from the same condition and / or asking for advice from psychologists who are experts in chronic diseases.
ASSESSMENT 2 CASE STUDY7 References Aitken R., Manias E. & Dunning T. (2006). Documentation of medication management by graduate nurses in patient progress notes: a way forward for patient safety.Collegian.13(4):5–11 Brazeau A. S., Rabasa-Lhoret R. & Strychar I, et al. (2008). Barriers to physical activity among patients with type 1 diabetes.Diabetes Care.31:2108–9. [PMC free article] [PubMed] Bullock, S & Manias, E. (2017).Fundamentals of Pharmacology (8e).Pearson. Bullock, S., & Manias, E. (2013).Fundamentals of Pharmacology. Melbourne: P.Ed Australia. Florence, A. T. (2015).Physicochemical principles of pharmacy: In manufacture, formulation and clinical use. London: Pharmaceutical Press. Fogarty G. J. & McKeon C. M. (2006). Patient safety during medication administration: the influence of organizational and individual variables on unsafe work practices and medication errors.Ergonomics.49:444–56. George, C. M., Byun, A., & Howard-Thompson, A. (2018). New Injectable Agents for the Treatment of Type 2 Diabetes Part 1 - Injectable Insulins.The American Journal Of Medicine, 131(7), 752-754. doi:10.1016/j.amjmed.2018.01.049 Gibney M. A., Arce C. H., Byron K. J. & Hirsch L. J. (2010). Skin and subcutaneous adipose layer thickness in adults with diabetes at sites used for insulin injections: Implications for needle length recommendations.Curr Med Res Opin. 26(6):1519-1530. 3. Goldman-Levine, J. D. & Lee, K. W (2005). Insulin Detemir--A New Basal Insulin Analog. The Annals of Pharmacotherapy 39: 502-507. In Qureshi, Z., & In Maxwell, S. R. J. (2014).The Unofficial Guide to Prescribing e-book. Churchill Livingstone
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ASSESSMENT 2 CASE STUDY8 Masse, M., Maton, M., Genay, S., Blanchemain, N., Barthélémy, C., Décaudin, B., & Odou, P. (2018). In vitro assessment of the influence of intravenous extension set materials on insulin aspart drug delivery.Plos One, 13(8), e0201623. doi:10.1371/journal.pone.0201623 Rossetti, P., Porcellati, F., Bolli, G. B., Fanelli, C. G. (2008). Prevention of Hypoglycemia While Achieving Good Glycemic Control in Type 1 Diabetes: The role of insulin analogs. Diabetes Care31: S113-S120 . Skyler, J. S. (2004). Effects of Glycemic Control on Diabetes Complications and on the Prevention ofDiabetes. Clin. Diabetes22: 162-166 Wallace T. M. & Matthews D. R. (2004). Recent advances in the monitoring and management of diabetic ketoacidosis.QJM. 97:773–80. [PubMed]