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What is the most appropriate insulin pen needle length for Ben and why?

What diabetes specific nursing assessment would you conduct prior to administration of Novo Rapid insulin to Ben and why?

Explanation of Novo Rapid Insulin prescription for Ben

The eleven components include the name of the drug or medicine, the name of the patient, the date of manufacture of the drug, the date of order of the drug, time at which the drug is administered, the dose administered, the site of injection, the route of administration and finally the number or frequency with which the drug is administered (Johnson et al., 2018). The importance of this components in the case of Ben is to avoid giving the wrong drug to the wrong patient .It generally reduces negligence among nurses.

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. (10 marks)


Ben has been prescribed Novo Rapid since it is a quick acting modern day insulin. The importance of the synthetic Novo Rapid insulin is to breakdown excess glucose in the blood. Diabetes Mellitus is a condition in which there is defects in the B-cells of the islets of Langerhans and this makes it impossible for the body to produce insulin (Rushakoff & Macmaster, 2018). This leads to elevated levels of the glucose in the blood. Novo Rapid acts by breaking down excess glucose in blood to produce less harmful substances like the glycogen.

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. (5 marks)

The onset of action of Novo Rapid is immediately after it is injected at the subcutaneous. However, the study noted that the peak of action is 10 minutes after it is injected. The duration of action of Novo Rapid is estimated to be 20 minutes (Manias & Bullock, 2017). One of the recommendation by the study is that the drug should be preferable injected before the patient eats any meal so as to prevent hypoglycaemia.

Discuss the definition, causes, symptoms and treatment of hypoglycaemia, a common adverse effect of Novo Rapid. Support your answer with academic references. (5 marks)

Hypoglycaemia is a healthcare condition in which the level of glucose in blood is lower than the normal. The normal levels of glucose in the body should be between 70 mg/dl which is equivalent to 3.9 mmol/L. In case a blood sugar test is carried and results go below those values, then that is hypoglycaemia (Rushakoff & Macmaster, 2018).Hypoglycaemia in the case of Ben is caused by the treatment of diabetes mellitus. The important signs and symptoms include fatigue, anxiety, excess hunger, an irregular heartbeat and blurred vision. Hypoglycaemia is treated through consuming fast acting carbohydrates. The common side effect of Novo Rapid is hypoglycaemia since the drug breaks down glucose and the levels might go below the normal levels.

Onset, Peak and Duration of Action for Novo Rapid Insulin


Discuss the importance of understanding the medication prior to administration. Support your answer with academic references. (5 marks)

Any healthcare professional should understand medication prior to administration. The healthcare professional should understand the dose, the mechanism of action, route of administration, the site of injection, the contraindications and the possible side effects of the medication (Rushakoff & Macmaster, 2018). Understanding medication enables the drug act well so that there is better patient outcome. It also minimizes the adverse effects of the medication to the patient.

Discuss the 5 rights of medication administration and why it is important for nurses to follow this procedure. Support your answer with academic references. (5 marks)

The five rights of medication include right dose, right site of injection, right frequency, right route and the right time (Rushakoff & Macmaster, 2018). It is important for the nurses to adhere to these rights so that the patient is subjected to the right medicine at the right time and the right dose so as to improve on their medical conditions without complications or without harm to the patient.

The gauge and the length of pen needle play crucial roles towards efficacy of the drug as well as the healing process at the site of injection. According to different studies, it has been established that the best length and gauge for administering insulin in the case of Ben is 25-28 gauge (Rushakoff & Macmaster, 2018). The length is supposed to be between 3/8-5/8.It is very important to consider the length and gauge so that there are no complications after injections such as ulceration

There should be certain nursing interventions before any drug is administered to the patient. For the case of Ben for example, the nurse is supposed to ask how good he is at adhering on medication, some of the allergies (Sousa, Castro, Fonte, & Sarmento, 2015). The other important nursing intervention is education on the importance of adhering to medication as it is of the patients benefit.


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. (5 marks)

The recommended site of injection is the abdomen. The nurse is supposed to pinch a fold then inject the needle at an angle of 90 degrees into the subcutaneous (Sousa, Castro, Fonte, & Sarmento, 2015). Studies recommend the subcutaneous where Novo Rapid acts quickly. They discourage injecting at the muscles due to the pain as well as delayed reaction of the insulin.

Definition, Causes, Symptoms and Treatment of Hypoglycemia

What would you document and where? Why is documentation important? Support your answer with academic or clinical guideline references. (5 marks)

Documentation generally refers to recording of the occurrence while providing nursing care to the patient .In this case the details that should be documented include the name of the patient which is Ben in this case, the date of admission at the healthcare facility, the type of medicine used, the side effects and the frequency at which the medication was administered (Chen et al., 2018). The importance or the rationale of documentation is just to ensure accountability and avoid negligence or mix up.

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)

After administering insulin to Ben, the nurses should provide certain specific nursing assessment. The assessment in this case includes educating the patient on proper diet so that he does not suffer from hypoglycaemia. Ben should also be educated on how well he should take care of wounds. Studies have found out that majority of patients with diabetes end up developing wounds on their legs. The Ben should also be assessed on how well he adheres to medication.

Discuss the daily physical challenges of living with type 1 diabetes that Ben may face. Support your answer with academic references. (5 marks)

One of the physical challenges is that Ben might fail to engage in daily activities like reading since diabetes causes a blurred vision .Ben might also be restricted to move around due to fatigue (Colberg et al., 2016). Fatigue is caused by the attempts of the body to breakdown excess glucose in the body. Ben might also be restricted from playing since it leads to loss of water yet patients with diabetes need a lot of water to maintain the body at an isotonic state.

Discuss potential emotional impacts of living with type 1 diabetes that Ben may face. Support your answer with academic references. (5 marks)

.Ben is likely to suffer from stress. Diabetes leads to stress among the patients since they have to go through a lot alterations in their normal lives such as diets ("Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331?288 participants," 2015). Most of the patients are supposed to feed on cabbage which most of them do not like. Anxiety is another emotional impact since patients are anxious if they will ever get better (Semenkovich, Brown, Svrakic, & Lustman, 2015). Depression is another emotional impact since the patients might be discriminated by others in taking part of activities.

References

Chen, X., Wong, B. C., Chen, H., Zhang, S., Bian, Z., Zhang, G., … Yang, Z. (2018). Long-lasting Insulin Treatment Via a Single Subcutaneous Administration of Liposomes in Thermoreversible Pluronic® F127 Based Hydrogel. Current Pharmaceutical Design, 23(39), 6079-6085. doi:10.2174/1381612823666170509123844

Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., … Tate, D. F. (2016). Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care, 39(11), 2065-2079. doi:10.2337/dc16-1728

Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331 288 participants. (2015). The Lancet Diabetes & Endocrinology, 3(8), 624-637. doi:10.1016/s2213-8587(15)00129-1

Johnson, M., Weidemann, G., Adams, R., Manias, E., Levett-Jones, T., Aguilar, V., & Everett, B. (2018). Predictability of Interruptions During Medication Administration With Related Behavioral Management Strategies. Journal of Nursing Care Quality, 33(2), E1-E9. doi:10.1097/ncq.0000000000000260

Manias, E., & Bullock, S. (2002). The educational preparation of undergraduate nursing students in pharmacology: clinical nurses’ perceptions and experiences of graduate nurses’ medication knowledge. International Journal of Nursing Studies, 39(8), 773-784. doi:10.1016/s0020-7489(02)00008-1

Rushakoff, R. J., & Macmaster, H. W. (2018). Improving Emergency Insulin Administration. JAMA, 319(18), 1937. doi:10.1001/jama.2018.2106

Semenkovich, K., Brown, M. E., Svrakic, D. Management., & Lustman, P. J. (2015). Depression in Type 2 Diabetes Mellitus: Prevalence, Impact, and Treatment. Drugs, 75(6), 577-587. doi:10.1007/s40265-015-0347-4

Sousa, F., Castro, P., Fonte, P., & Sarmento, B. (2015). How to overcome the limitations of current insulin administration with new non-invasive delivery systems. Therapeutic Delivery, 6(1), 83-94. doi:10.4155/tde.14.82

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