different types of insulins

BACHELOR OF NURSING SCIENCE OR MIDWIFERY DUAL DEGREE
NUR 231 – Drug Therapy Case Study – SEMESTER 1, 2018
Copyright USC @2010
LL
“”Updated”:”J.Hanson”/Marc”Broadbent”December”2017“”””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””
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NUR 231 DRUG THERAPY – ASSESSMENT TASK 2 – CASE STUDY
This case study assignment is designed for nursing students undertaking the Bachelor of Science
degree or midwifery students undertaking the dual degree. Dual degree student may complete this
case study or choose the midwifery pregnancy case study. This case scenario is based on theory,
concepts and professional practice principles covered in lectures, tutorials and associated resources. It
is designed to develop knowledge and problem-solving skills that apply to decision-making and safe
drug administration in complex health care settings.
Assessment requirements:
Submission: Submit your assessment to blackboard online via safe assign
Formatting: Format using 1.5 line spacing and Times New Roman 12.
Word Count: 2,500 words +/- 10% (includes in-text references and excludes reference list)
Marking Criteria: All questions must be completed according to the marking criteria to achieve a
satisfactory grade.
References: In-text references are included in the word count. (The reference list is not included in
the word count). Please use academic sources of information such as the texts used in this course and
peer reviewed journal articles to support all your answers. Other trustworthy sites include
Government-operated websites and NPS MedicineWise.
Completion Guidelines
The case study assignment is an Individual Assessment Item.
You may work collaboratively with other students to understand concepts in this course but
your answers must be your individual research, interpretation and application of the
materials. All answers must be supported by relevant references to the literature.
Answers that show evidence of deliberate copying from other student’s work will be
investigated as collusion. Answers that show evidence of deliberate copying from authors will
be investigated as plagiarism. Collusion and plagiarism are considered to be academic
misconduct and academic penalties apply. For more information see the Bb+ assessment area,
course outline or USC policy at https://www.usc.edu.au/explore/policies-andprocedures/student-academic-integrity-governing-policy
*Remember to save a copy of your work on an external drive or USB.
“”Updated”:”J.Hanson”/Marc”Broadbent”December”2017“”””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””
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INTEGRETED PATHOPHYSIOLOGIC CONCEPTS – GLUCOSE,
INSULIN, ENERGY AND THE PANCREAS!
Consider the patient Situation
Tony Barrett is a newly diagnosed insulin-dependent diabetic. Tony is 14 years old, weighs 51 kg
(non-obese) and has always been very active. He usually plays football at weekends and enjoys
swimming. He regularly goes to the beach to surf with his friends enjoys and is a member of the local
surf lifesaving club. Over the last month, Tony has been constantly thirsty and often hungry. He has
been passing urine frequently and having to get up to the toilet in the night. His father became
concerned when he noticed that Tony lost interest in sports and being with his friends because he was
complaining of headaches and felt tired all the time.
Five days ago, Tony was reviewed by an endocrinologist and diagnosed with Type 1 Diabetes
Mellitus. The endocrinologist prescribed a ‘basal-bolus’ regime of insulin consisting of Insulin aspart
(Novorapid) before each meal and Insulin glargine (Lantus) flexipen before bedtime. Yesterday, Tony
had a hypoglycaemic episode at school (BGL 3.0 mmol/L) and was transferred to hospital. He
suffered a further hypoglycaemic episode on waking this morning but 15 minutes after drinking ½ cup
of fruit juice his BGL was 4.4 mmol/L. Tony and his family are anxious to learn how to manage his
blood glucose levels (BGLs) before he is discharged home.
Section 1 – Pathophysiologic and pharmacologic concepts
Collect information: Pathophysiology
Q1. Outline the pathophysiology of type I (Insulin –dependent) diabetes.
Process information: Pharmacologic concepts in glycaemic management
Q2. What specific information do Tony and his family need to know about insulin absorption in order
to manage the insulin regime at home? Discuss your answer in relation to:
a) The ‘Time-course of formulations’ of insulin and the effect on absorption of
insulin
b) The appearance of different types of insulins
c) The principles underpinning a ‘basal-bolus’ regime of insulin
d) The practical skills and knowledge Tony needs to self-administer insulin
“”Updated”:”J.Hanson”/Marc”Broadbent”December”2017“”””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””
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INTEGRATED PATHOPHYSIOLOGIC CONCEPTS – GLUCOSE,
INSULIN, ENERGY AND THE PANCREAS
Q3. From your knowledge of pharmacodynamics, explain how insulin works to reduce blood glucose
level.
Q4. Identify 3 objective tests that may be used to assess Tony’s current glycaemic status ie. how
would you know if Tony was stable or unstable?
Section 2 – Decision-making
Synthesise the information
Q5. Examine the information that you have about Tony’s presentation to hospital and identify two
possible nursing diagnoses from the following options. Tony has:
a) hypoglycaemia possibly related to excessive carbohydrate intake
b) hyperglycaemia possibly related to inadequate carbohydrate intake
c) hyperglycaemia possibly related to excessive carbohydrate intake
d) hypoglycaemia possibly related to inadequate carbohydrate intake
e) hypoglycaemia possibly related to inadequate insulin administration
f) hypoglycaemia possibly related to inappropriate insulin administration”
Establish goals
Q6. Before initiating any actions, it is important to be clear about your goals for Tony.
(i) What goal would you set regarding Tony’s Blood Glucose Levels (BGLs)?
(ii) What goals would you set regarding Tony’s knowledge deficit?”
Take action
Q7. What are your nursing actions in the event that Tony is found to be:
(a) hypoglycaemic (BGL <3.5mmol/L) and conscious?
(b) hypoglycaemic (BGL <3.5mmol/L) and unconscious/altered consciousness?
Give a rationale for your clinical decisions and actions in Q7a and Q7b.
“”Updated”:”J.Hanson”/Marc”Broadbent”December”2017“”””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””””
5″|”P a g e ”

INTEGRATED PATHOPHYSIOLOGIC CONCEPTS – GLUCOSE,
INSULIN, ENERGY AND THE PANCREAS
Section 3 – Professional standards
Q8. Choose 2 ethical value statements and 2 standards for practice that will guide your nursing care of
Tony and his family whilst in hospital and/or in discharge planning activities. Give examples of how
the 2 value statements and the 2 standards apply to this case.
Q9. The central principles of social justice in the health care context are self-determination, equity,
access and rights and, participation. Health professionals have an ethical obligation to ensure that
patients are treated fairly. Discuss how psycho-social factors in Tony’s life might impact on how he
participates in his own health care (including medication adherence), and interacts with health
professionals?
Q10. Write down what actions will you take in your future practice because of what have learned
from this scenario?
Section 4 – Conveys scientific information
Check your answers and ensure that you have used professional language throughout your
assignment. Proof read for logical structure, accuracy and clarity.
Section 5 – Sources of evidence
There are 2 parts to section 5 of the marking criteria: (i) ensure that you have examined academic
sources of information and used them in support of all your answers. Avoid websites designed for
patient information and check that any websites you do use are directed towards health professionals,
and are current and peer reviewed (ii) ensure that you have a minimum of 8 references.
SUBMIT TO BLACKBOARD ONLINE VIA SAFE ASSIGN. THANK YOU