Case Study
Aim of the assessment
The purpose of this assessment is to enable students to demonstrate:
– An
understanding of safe, appropriate and responsive quality nursing practice when
administering pharmaco-logical interventions to people with type 1 diabetes
–An
understanding of the relationship between pharmacological interventions and the
cause, pathophysiology and clinical manifestations of type 1 diabetes
– An understanding of the impact of type 1
diabetes on the individual
– An evaluation
of relevant literature to support an understanding of the pharmacological and
nursing management of a person with type 1 diabetes and express this in a clear
and succinct writing style
Case study
You are a Registered Nurse working in the emergency department caring
for Ben Summer who is 19 years of age.
Medical history
Ben visited his local doctor after experiencing
increased appetite and excessive thirst. He has been unusually tired when
playing football and hasn’t been able to perform at his best. He has lost 10
kilograms of weight over a two week period and has been frequently urinating at
night. The doctor suspected type 1 diabetes and tested his urine, which was
positive for glucose and ketones. A random capillary blood glucose level was 25.0mmol/L
and blood ketone level was 1.5mmol/L. Ben was advised to attend the hospital
emergency department immediately.
Social history
Ben lives with his mother (Susan), father (John)
and 12 year old brother (Jacob). He attends university full time, studying
engineering and works at McDonalds on a casual basis. Ben plays football on the
weekends and trains two days during the week. He has a girlfriend Rachel and
they both enjoy surfing at the beach.
Emergency department
review
Two hours after review by the local doctor, Ben’s
capillary blood glucose level was 26.0mmol/L and blood ketone level was
1.6mmol/L. Other vital signs were within normal limits. After review by the
endocrinologist, Ben was given a provisional diagnosis of type 1 diabetes based
on his symptoms and family history of autoimmune disease (His mother has
hyperthyroidism, Graves’ disease). His blood test confirmed that he did not
have ketoacidosis.
Treatment plan
Ben was prescribed subcutaneous insulin; Aspart
(NovoRapid) Flexpen 10 units TDS and Glargine (Lantus) Solostar 30 units nocte.
He was referred to the diabetes service for ongoing care.
Case study questions
Using the marking criteria and supporting academic references address
the following questions.
Part A (60 marks, suggested 800 words)
The nursing responsibilities related to the administration of Aspart
(NovoRapid) insulin to Ben.
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. (5 marks)
2.Explain why Ben has been prescribed this
medication. Relate to the pathophysiology of type 1 diabetes and the mechanism
of action of NovoRapid insulin. Support your answer with academic references.
(10 marks)
3.What is the onset, peak and duration of action
for NovoRapid insulin according to Bullock and Manias (2017)? Explain when
NovoRapid should be administered in relation to food intake and why. Support
your answer with academic references. (5 marks)
4.Discuss the definition, causes, symptoms and
treatment of hypoglycaemia, a common adverse effect of Novo-Rapid. Support your answer with
academic references. (5 marks)
5.Discuss the importance of understanding the
medication prior to administration. Support your answer with academic
references. (5 marks)
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. (5 marks)
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 NovoRapid insulin to Ben and why?
Support your answer with academic references. (5 marks)
9.Identify the site and angle you would inject the
NovoRapid insulin and explain why this was selected for Ben. Discuss infection
control considerations. Support your answer with academic references. (5 marks)
10.What would you document and where? Why is
documentation important? Support your answer with academic or clinical
guideline references. (5 marks)
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. (5 marks)
Part B (10 marks, suggested 200 words)
The potential impact of type 1 diabetes on Ben.
1.Discuss the daily physical challenges of living
with type 1 diabetes that Ben may face. Support your answer with academic
references. (5 marks)
2.Discuss potential emotional impacts of living
with type 1 diabetes that Ben may face. Support your answer with academic
references. (5 marks)
Language
Use (5 marks): Sentences are well constructed,
expression and meaning is clear, basic written language rules are followed.
Referencing
and in-text citations (5
marks): The APA referencing style is used correctly for both in-text ci-tations
and reference list.
NOTES: The assessment must comply with the following:
–Students
must respond to each of the questions provided using academic writing -
question/answer format using full sentences and paragraphs
– An introduction and conclusion are NOT
required.
– Please type your responses on the template
provided in the assessment tab on vUWS.
– The assessment has double -spaced lines. Arial
12 size font.
–
Referencing must be presented in American Psychological Association (APA) (6th
ed.) referencing style as per the Western Sydney University (2016) American Psychological Association
referencing style guide. Available from:
https://library.westernsydney.edu.au/main/sites/default/files/cite_APA.pdf
– Every
answer should have in-text references. In-text references should be throughout
the answer and not only at the end of
a whole paragraph.
– No initials of authors’ first name are used in
the in-text references.
– Reference list is on a new page.
– References are listed in alphabetical order
based on the first author’s surname.
– Hanging indent has been used in the reference
list.
– Title of text book and name of journal and
volume is in italics.
– Every in-text reference matches with a
reference in the reference list.
– There is
a limit of 1000 words +/- 10%. Use your computer to total the number of words
used in your assignment.
– The questions and reference list are not
included in the word limit.
– In-text
citations will be included in the additional 10% word count. If you exceed the
word limit by more than 10% the marker will stop marking at 1100 words.
– Academic references include journal
articles, textbooks, Australian clinical guidelines and creditable
organi-sational websites/reports such as The Australian Diabetes Educators
Association.
– High quality academic references are
current (within 5 years) and specifically relevant to type 1 diabetes or
insulin administration.
Resources:
i. Examples may be available on the vUWS site.
ii. There are a number of textbooks and
resources available through the Western Sydney University Library that may
assist you. Please refer to the unit’s vUWS site for specific unit resources
Literacy resources: The School of Nursing and
Midwifery have qualified staffin the teaching of English language and literacy
who are available to support all students in Professional Communication and
Academic Literacy (PCAL) Skills on each campus. Contact details below. Please
email for PCAL Support workshops, small group and individual appointments.
Hawkesbury Campus NM_Hawkesbury_Literacy_Tutors@westernsydney.edu.au
Campbelltown Campus NM_Campbelltown_Literacy_Tutors@westernsydney.edu.au
Parramatta Campus NM_Parramatta_Literacy_Tutors@westernsydney.edu.au Liverpool
Campus NM_Liverpool_Literacy_Tutors@westernsydney.edu.au
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