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PD2013_043 Medication Handling In NSW Public Health Facilities
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PD2013_043 Medication Handling In NSW Public Health Facilities
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Course Code: PD2013_043
University: Government Of New South Wales
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Country: Australia
Question:
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.
2.Explain why Ben has been prescribed this medication. Relate to pathophysiology of type 1 diabetes and the mechanism of action of Novo Rapid insulin. Support your answer with academic references.
3.What is the onset, peak and duration of action for Novo Rapid insulin according to Bullock and Manias (2017)? Explain when Novo Rapid should be administered in relation to food intake and why. Support your answer with academic references.
4.Discuss the definition, causes, symptoms and treatment of hypoglycaemia, a common adverse effect of Novo Rapid. Support your answer with academic references.
5.Discuss the importance of understanding the medication prior to administration. Support your answer with academic references.
6.Discuss the 5 rights of medication administration and why it is important for nurses to follow this procedure. Support your answer with academic references.
7.What is the most appropriate insulin pen needle length for Ben and why? Support your answer with academic references. (5 marks)
8.What diabetes specific nursing assessment would you conduct prior to administration of Novo Rapid insulin to Ben and why? Support your answer with academic references.
9.Identify the site and angle you would inject the Novo Rapid insulin and explain why this was selected for Ben. Discuss infection control considerations. Support your answer with academic references.
10.What would you document and where? Why is documentation important? Support your answer with academic or clinical guideline references.
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.
12.Discuss the daily physical challenges of living with type 1 diabetes that Ben may face. Support your answer with academic references.
13.Discuss potential emotional impacts of living with type 1 diabetes that Ben may face. Support your answer with academic references.
Answer:
Introduction
There are several components of a valid routine subcutaneous insulin medication order which are very important. The eleven most common components include the clients name ,type of medication ,the signature of the person ordering the medication, the time and frequency the medication should be given, the route of administration, the dosage, the medication name, the date of the order and finally the name of the client(Atkinson, Eisenbarth, & Michels, 2014). The importance of the components is just for effective monitoring and accountability.
Type 1 diabetes is a chronic condition in which the level of glucose is relatively high in the body due to impairment or use of insulin in the human body. Novo rapid is a modern insulin whose aim is to breakdown excess sugars in the body .Novo rapid is a very fast acting drug that will begin to lower the level of glucose 10-20 minutes after injection(Miller et al., 2015). Novo rapid has a type of insulin called insulin as part that starts to function immediately after it is injected under the skin.
Novo rapid is one of the short acting medications that are used for treating type one diabetes. The drug starts working immediately after it is injected under the skin. The peak for action of the drug is usually 10 minutes after injection and the duration for the action is usually a maximum of 20 minutes. This is in accordance to Bullock and Manias (2017).Novo rapid should be taken just before a meal so as to avoid the low level of glucose.
Hypoglycaemia is a condition in which the level of glucose goes below the normal range of 4mmol/L. There are several signs and symptoms of the condition but the common ones include sweating, fatigue, feeling dizzy, pale skin, weak, feeling hungry, blurred vision, confusion and loss of consciousness (Atkinson, Eisenbarth, & Michels, 2014).. The major causes of hypoglycaemia is medication of diabetes. Other factors linked to great risk include alcohol, delayed meals, exercise and high doses of insulin medication. Treatment include the use of fast acting carbohydrate like the glucose tablets and sweets,
It is very important to understand any medication prior to administration. This is just meant to ensure maximum efficacy of the drugs and prevent potential harm to the patient. There are some drugs which work best before meals like novo rapid while others work well after meals (Miller et al., 2015). .It is also important to understand the route of administration .Some drugs cannot work when taken using the wrong route .It is therefore very important for one to understand the medications before administration.
There are several rights on the medication administration and they are very important for nurses to follow. The rights include but not limited to the right dose, the right route, the right time, the right individual, the right medication and finally the right documentation (Lind et al., 2014). It is important for nurses to know these rights to avoid any complications with the patient. The rights are also important to ensure maximum recovery and reduce on the cases of confusion at the hospital.
The kind of needle volume, gauge and length is necessary to keep in mind before administration of insulin. For the case of Ben, the most appropriate insulin pen needle length is the 25-28 gauge, and 3/8-5/8 inches in length (Hering et al., 2016). The reason for the above length is to prevent ulcerations and complications of the underlying skin layers.
Prior to administration of the Novo Rapid drug, there are specific nursing assessments that should be carried out by the nurse. One of the assessment is to identify the patient so as not to administer to the wrong patient. After that, the nurse should inform Ben who is the patient (Hering et al., 2016). The nurse should again perform the third check just to confirm it is the right patient and then finally administer the drug. After that, the nurse should document the drug administered and finally evaluate the client’s response to the drug 30 minutes later
There are several sites that are preferred for the subcutaneous injection of Novo rapid. The most preferred sites include the upper arm, upper back, the upper buttock, thighs and the abdomen (Beck et al., 2017). The best site for Ben would be at the front of the waist or the abdomen and this is actually selected because Novo rapid works immediately or quickly at that particular site .For infection control considerations, there should generally be proper hygiene control such as good foot care and urinary hygiene.
During the course of treatment, documentation is very important for purposes of accountability. There are different aspects that should be documented and they include the name of the medication provided, the dosage given, the route of administration and the site of injections, the time the drug was administered, the initials and finally the signature(Lind et al., 2014). Documentation is important as it prevents administration of the wrong medications to the wrong patients.
A healthy diet and monitoring the glucose levels are the best assessments after treatment with insulin. The nurses should also check for any side effects of the drugs. There should also be considerations to prevent infections since patients with diabetes type one are prone to infections (Chiang, Kirkman, Laffel, & Peters, 2014). The nurses should therefore provide proper hygiene to prevent foot infection as well as UTIs.
Discuss the potential impact of type 1 diabetes on Ben.
Diabetes type 1 is a disease that poses great physical challenges to those individuals diagnosed with the condition. One such physical challenge is exhaustion. The fluctuating levels of glucose in the body usually bring an individual from one end to another and may as well alter the moods of the patient. Ben might be called upon to eating so much cabbages to treat low glucose that subsequently goes high. This makes the body very confused (Miller et al., 2015). This eventually leads to exhaustion.
Another physical challenge that Ben might encounter is Burn out. Diabetes will always dictate one to regular checking or diagnosis many times a day. Besides, It calls for regulation of the hormone insulin several times a day and this leads to complete burn out of the patients. The disease also causes fatigue in patients.
Since diabetes type 1 is a chronic condition, individuals who are diagnosed with the condition are likely to be negatively impacted emotionally. The most common emotional impact or potential emotional impact on Ben is likely to be stress. Stress is very common because this condition needs management on a daily basis (Miller et al., 2015). Stress arise due to the daily diagnosis, medications as well as monitoring the type of food one eats.
References
Atkinson, M. A., Eisenbarth, G. S., & Michels, A. W. (2014). Type 1 diabetes. The Lancet, 383(9911), 69-82. doi:10.1016/s0140-6736(13)60591-7
Beck, R. W., Riddlesworth, T., Ruedy, K., Ahmann, A., Bergenstal, R., & Haller, S. (2017). Effect of Continuous Glucose Monitoring on Glycemic Control in Adults With Type 1 Diabetes Using Insulin Injections. JAMA, 317(4), 371. doi:10.1001/jama.2016.19975
Chiang, J. L., Kirkman, M. S., Laffel, L. M., & Peters, A. L. (2014). Type 1 Diabetes Through the Life Span: A Position Statement of the American Diabetes Association. Diabetes Care, 37(7), 2034-2054. doi:10.2337/dc14-1140
Hering, B. J., Clarke, W. R., Bridges, N. D., Eggerman, T. L., Alejandro, R., Bellin, M. D., … Turgeon, N. A. (2016). Phase 3 Trial of Transplantation of Human Islets in Type 1 Diabetes Complicated by Severe Hypoglycemia. Diabetes Care, 39(7), 1230-1240. doi:10.2337/dc15-1988
Lind, M., Svensson, A., Kosiborod, M., Gudbjörnsdottir, S., Pivodic, A., Wedel, H., … Rosengren, A. (2014). Glycemic Control and Excess Mortality in Type 1 Diabetes. New England Journal of Medicine, 371(21), 1972-1982. doi:10.1056/nejmoa1408214
Miller, K. M., Foster, N. C., Beck, R. W., Bergenstal, R. M., DuBose, S. N., DiMeglio, L. A., … Tamborlane, W. V. (2015). Current State of Type 1 Diabetes Treatment in the U.S.: Updated Data From the T1D Exchange Clinic Registry. Diabetes Care, 38(6), 971-978. doi:10.2337/dc15-0078
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