The goal of this task is to know and apply professional, ethical and legal codes and standards to decision making and safe medication practice. You will interpret and use evidence to support evidence-based and responsive practice when managing a medication regime.
Please open a new WORD document and remove all formatting from the case study booklet provided. Answer each question as Q1…(answer); Q2…(answer) and so on. Include your in-text references and reference list in the document (do not submit you reference list as a separate document as safe assign will only accept one document). Upload your completed assignment to Bb via SafeAssign. Word count 2,500 +/- 10%.
Australian Diabetes Educators Association (ADEA). Clinical Guiding Principles for Subcutaneous Injection Technique. Canberra: 2015.
Australian Medicines Handbook (AMH) and AMH Aged Care Companion – available via USC library databases – Specialist Resources section.
Braun, CA & Anderson, CM 2017, Applied pathophysiology: A conceptual approach to the mechansims of disease, 3rd edn, Wolters Kluwer Health, Philadelphia – available in the library – see course reserve.
Bryant, B & Knights, K 2015, Pharmacology for Health Professionals, 4th edn, Elsevier, Chatswood – available in the library – see course reserve.
McKenna, L & Mirkov, S 2014, McKennas Drug Handbook for Nursing and Midwifery, 7th edn, Lippincott Williams & Wilkins, Sydney – see course reserve.
MIMS Online – available via USC library databases – specialist resources section.
Nursing and Midwifery Board (new) Professional Codes and Guidelines effective from March 1st 2018.***Please note that the wording has changed in the new Code of Ethics. From March 1st 2018, -value statements- have been replaced by -elements-.
Tiziani, A 2017, Havards Nursing Guide to drugs, 10th edn, Elsevier, Chatswood – see course reserve.
Resources can be found at the USC blackboard Referencing site. Use Harvard referencing as per USC guidelines. In-text references are included in the word count as per normal academic standards. The reference list is notincluded in the word count.
BACHELOR OF NURSING SCIENCE OR MIDWIFERY DUAL DEGREE
NUR 231 – Drug Therapy Case Study – SEMESTER 1, 2018
Copyright USC @2010
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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.
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.
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 students 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.
INTEGRETED PATHOPHYSIOLOGIC CONCEPTS 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
INTEGRATED PATHOPHYSIOLOGIC CONCEPTS 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
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?
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.
INTEGRATED PATHOPHYSIOLOGIC CONCEPTS 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.