Drug Therapy
Criterion 1: Application of pathophysiological concepts to justify clinical decision-making
As a nursing student, your clinical facilitator has allocated you to care for Jarrah. After the morning handover, you are asked to explain the pathophysiology of type 1 diabetes to the clinical facilitator. What is your response?
Your clinical facilitator tells you that Jarrah would rather not have multiple daily injections. He wants to know why he cannot just have tablets to manage his type 1 diabetes like his friend who has type 2 diabetes. What is your response?
Criterion 2: Application of pharmacotherapeutic concepts to explain safe medication practice
Jarrah is disappointed that he has to administer two different types of insulin. Your clinical facilitator asks if you can explain to her how Jarrah’s prescribed regime works to achieve glycaemic control.
Explain the ‘time-course’ of formulations of NovoRapid and Optisulin.
Explain the principles underpinning a ‘basal-bolus’ regime of insulin (see Bryant & Knights, 2019, p. 682 – 683).
*See also MimsOnline 2022 Full Prescribing Information NovoRapid and Optisulin
Explain the mechanism of the action of NovoRapid and Optisulin in attaining glycaemic control.
Criterion 3: Evidenced based argument and justification of decisions
Identify problems/issues
You are on a night shift and Jarrah rings his bell at 0200hrs and states he feels unwell. You take his blood glucose level (BGL) and find it to be 3.0mmol/L. This is the second consecutive night this has happened.
What are the registered nurse’s responsibilities relating to the Nursing and Midwifery Board of Australia (NMBA) Registered Nurse Standards for Practice in providing safe care to Jarrah?
Identify one standard and apply it to your responsibility in this situation.
Identify two possible causes of his hypoglycaemia.
Take action
What are the appropriate nursing actions after taking Jarrah’s BGL? Give a rationale for the nursing actions.
If Jarrah appears to have altered consciousness, explain the nursing actions you would take and provide a rationale.
Criterion 4: Application of social justice principles and the Quality Use of Medicines when describing mechanisms of action, adverse effects, benefits, risks and management of pharmacotherapy using person-centred approaches
Jarrah is struggling to come to terms with his type 1 diabetes diagnosis and the need to have multiple daily injections.
What information would you give him about the long-term benefits of having the insulin and closely monitoring his BGL?
What information would you provide to Jarrah and his father about recognising symptoms of hypoglycaemia?
What education would you provide regarding techniques around self-administration of insulin?
Identify one aspect that you would have to consider in relation to social justice. How could this impact Jarrah’s ongoing health needs? What solution might you offer to address this?
What issues could affect Jarrah’s ongoing glycaemic control in relation to a) his age and b) engagement in sport once he is discharged?
