401209 Health Variations For Chronic Assessment Answer

1 Explain the causes, pathophysiology, clinical manifestations and diagnostic procedures for common chronic illnesses related to the endocrine, neurological and respiratory body systems.

2 Examine safe, appropriate and responsive quality nursing practices related to the administration of pharmacological interventions for chronic conditions affecting the endocrine, neurological and respiratory body systems.

3 Develop evidence-based rationales for safe, person-centred nursing practice to people with chronic illness and disability.

4 Apply critical thinking frameworks to analyse the impact of chronic illness and disability on the individual, family, caregivers and the health care system, and develop a plan for nursing practice.

5 Demonstrate an understanding of the principles of habilitation, rehabilitation, chronicity and disability and the implications for nursing practice.

Answer:

The components of a valid routine subcutaneous insulin medication for the case of Ben include name of the medicine, the route of administration, signature of the nurse, time of administration, frequency of administration, date of order, the dose rate, the side effects (Brashers, Jones & Huether, 2017).The importance of this components is to ensure proper medication to the right patient and incidences of where the wrong or expired medicine is given to the wrong patient. 

 Diabetes, a condition which Ben is suffering from, is a condition in which the body fails to produce insulin hormone and as a result, there is excess glucose in blood. Diabetes Mellitus is an autoimmune disease which means it is the immune system that destroys its own body. The immune system responds to chemical stimuli which in return destroys the B cells in the islets of Langerhans that are responsible for the production of insulin hormone (Hoy & Hethrington, 2013). Lack of production of insulin then leads to accumulation of excess glucose in the blood since it is insulin that breaks down the excess glucose to glycogen. The rationale as to why Ben has been prescribed the Novo Rapid drug is because this is a modern day insulin of the synthetic origin that acts quickly as compared to other drugs. This is simply to say that it has been preferred to other drugs because it acts faster in reducing the level of glucose in blood. The mechanism of action of the drug is simply breaking down of excess glucose to less harmful substances like the glycogen.

According to studies, it has been established that Novo Rapid is one of the best modern day insulin that can be used to treat Ben. (Bullock & Manias 2017). The studies have as well found out that the onset of working is immediately after injection in the subcutaneous. It is estimated that the peak is 10 minutes after injection and the duration for action is about 20 minutes. It is recommended that the drug should be administered before any meal to avoid hypoglycaemia. 

Hypoglycaemia is a condition in which there is a low level of glucose in the blood. The normal levels of blood glucose are either 70 mg/dl or 3.9 mmol/L (Arcus & New South Wales, 2013).Therefore, whenever the glucose level is below those values, that is hypoglycaemia and there should be immediate treatment for Ben who is the patient. The signs and symptoms for the condition include fatigue, anxiety, hunger, irritability, sweating, an irregular heart rhythm, pale skin and tingling sensation. The leading cause of hypoglycaemia is as a side effect to drugs that are used to treat diabetes such as Novo Rapid. The treatment option in hypoglycaemia involves consumption of fasting acting carbohydrates that are between 15-20 grams in weight. The most common adverse effect of the Novo Rapid drug is low blood glucose since it breaks down excess glucose in the body to form glycogen .

Before any drug is administered to the patient who is Ben in this scenario, the nurse should understand the medication properly .It is important for the nurse to understand the dosage, the mechanisms of action, the side effects, and the route of administration and time of administering (Arcus & New South Wales, 2013). All this is just to ensure that the desired medication acts in the best interest to the patient to promote wellness with very minimal effects to the patient .The right route for example assists the nurse to avoid using the wrong route so that the medicine acts quickly.

At the moment, there are seven rights of medication administration of drugs to Ben. They include right client, right dose, right time, right route, the right reason, and the right dose and finally the right documentation (Canberra, 2015). The importance of this rights is to ensure maximum benefits to the patient and avoid legal lawsuits in the future. The nurses are always advised to adhere to the seven rights to avoid entanglements with the law or the court.

Studies have shown that the needle length may affect the process of recovery as well as how effective the drug acts. For the purposes of insulin, it has been established that the appropriate or the best length for injection is that of between 25 and 28 gauge while the length should be between 3/8 to 5/8 (Canberra, 2015). The importance of adhering to this measurements is to avoid harm of other components of the skin to Ben like the melanin. This might lead to ulcerations.

Before Novo Rapid is administered to Ben, the nursing interventions include asking if he has any allergies for Novo Rapid medication (Brashers, Jones & Huether, 2017). The nurse should also explain the importance of the treatment regimen that Ben is being subjected to .Inquiry on how the patient adheres to medication is the final assessment.

Novo Rapid is the modern insulin. However, the insulin should be injected at the correct site and angle to Ben who is the patient. According to studies, it has been established that Novo Rapid should be injected into the subcutaneous and not the muscles as it causes a lot of pain and the benefits may not be long lasting (Canberra, 2015).It is recommended therefore that the nurse should pinch a fold of the skin and inject the needle at 90 degrees.

The best site for injection of Novo Rapid to Ben according to studies is the abdomen. It has been established that the onset of reaction of novo rapid is much faster at the abdomen than any other site. However, there should initial sterilization before injection to prevent infections at the site of injection.

Documentation in nursing is the process or recording whatever happened or was done to the patient who is Ben in this case. There are different components that are usually documented during nursing intervention. Name of the patient, Date of admission, drugs used, side effects, dosage of the drugs (Craig ME et al., 2014). Documentation is very important since it ensures accountability and prevents confusion. This is because in the event there is no documentation, a nurse might confuse and administer the wrong drug to the wrong patient and this complicates the patient’s situation .Documenting side effects on the other hand assists the nurses to change the treatment regimen in case the side effects are adverse.

After administration of insulin, there are usually specific nursing assessment to prevent exercabations of the condition that Ben is suffering from. The specific nursing assessments to Ben include reviewing the client’s current diet as well as the nutritional needs (Craig ME et al., 2014). Educating the client about proper wound care is another important nursing assessment and finally educating the patient on the importance of adhering diabetic treatment on a consistent basis. The rationale behind this nursing assessment is to ensure efficient flow of blood and reduce the risks for delayed wound healing. 

Diabetes comes with a lot of physical challenges. Ben may encounter a lot of these challenges. One such challenge is the inability to engage in any physical activities since he will be feeling fatigued nearly most of the time (Ambler, Cameron & Gillbank, 2010).This is brought about by the attempts of the body to breakdown excess glucose while excreting the waste products at the same time.

Another important physical challenge that might affect Ben is inability to move around freely. In the event that the diabetes is not managed well, Ben may develop wounds especially on the foot. These wounds normally take time to heal and will therefore restrict Ben from moving from one place to another .Impairment in vision also restricts the patients from engaging in different physical activities like reading. Blurred vision is a symptom of diabetes and affects how well the patient carries out his or her daily life.

Diabetes is a condition in which the level of blood glucose is extremely high. This is caused by the defects in the production of insulin. This condition is associated with emotional impacts .One such impact that Ben is likely to encounter is stress. Diabetes leads to stress among the patients since they have to go through strenuous medications frequently. Another emotional impact to Ben is anxiety (Ambler, Cameron & Gillbank, 2010). The patients are always anxious if the condition will ever get better. Depression is another emotional impact which can affect Ben since it comes along with type 1 diabetes. The idea of being subjected to medication frequently makes the patients to be depressed 

References

Hoy,A, & Hethrington,J. (2013). Alterations of endocrine function across the life span.

Arcus, J., & New South Wales. (2013). Medication Handling in NSW Public Health Facilities. Gladesville, N.S.W: NSW Health Dept.

Bullock, S., & Manias, E. (2002). The educational preparation of undergraduate nursing students in pharmacology: a survey of lecturers' perceptions and experiences. Journal of Advanced Nursing, 40(1), 7-16. doi:10.1046/j.1365-2648.2002.02335.x

Canberra. (2015). Clinical Guiding Principles for Subcutaneous Injection Technique.

Craig ME, Jefferies C, Dabalea D, Balde N, Seth A, & Donaghue KC. (2014). Definition,epidemiology ,and classification of diabetes in children and adolescents.

Ambler,G, Cameron,F,, &  Gillbank,J. (2010). Caring for Diabetes in Children and Adolescents (3rd ed.).

Tracy Parrish. (2013). Nursing Care of People with Diabetes Mellitus.

Brashers, V.L,, Jones,R.E, & Huether,S.E,. (2017). Chapter 22. In Alterations of Hormonal Regulation.