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)

Part A

Answer-1: 

The 11 components of a valid routine subcutaneous insulin order are discussed below. 

1. Patient's demographics, including gender, date of birth, residential address, URN, and names of the family members. 
2. Initial prescriber ID
3. NIMC (National Inpatient Medication Chart)
4. Hospital Information 
5. The physician who requires notification 
6. Prescriber's signature and printed name 
7. Date
8. Insulin detail/name
9. Recommended dosage
10. Administration schedule (i.e. pre-meal or post-meal)
11. Physician's initials 

Ben's identification validation substantiates the need for mentioning the patient's unit record number and demographics on the medication order. Each URN effectively identifies a single patient in the healthcare database (DOH, 2015). Demographics documentation and assessment substantially reduces the risk of insulin administration to the wrong patient (ACSQHC, 2012). Physician's dosage and schedule documentation facilitates the utilization of an appropriate injection administration technique for the concerned patient (ADEA, 2015). 

Answer-2: 

Ben has been diagnosed with type I diabetes. Ben had been genetically predisposed to the autoimmune deterioration of his beta cells. The interaction of his genes with environment impacted his human leucocyte antigen. This resulted in insulitis and reduction in insulin secretion. The elevated breakdown of Ben's body proteins and fats elevated his blood glucose level to an abnormal extent (i.e. hyperglycemia). Novo-Rapid insulin therapy effectively minimizes the toxic impact of hyperglycemia and associated metabolic load (Marshall, Lapsley, Day, & Ayling, 2014, p. 310). Subcutaneous insulin also reduces gluconeogenesis/glycogenolysis and elevates protein synthesis (Bullock & Manias, 2017, p. 752).

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