Question

Develop a detailed teaching plan with an emphasis on self-management. Be sure to include a collaborative suggestion for another professional who would be involved in the teaching plan. Inclusion of culture, client developmental level, and socioeconomic factors should be considered. A 38-year-old female patient with type one diabetes. Despite being on mealtime sliding scale insulin and long-acting insulin once a day, her A1C is 9.9%. The patient’s provider asked you to speak with the patient to determine if she is taking her insulin correctly. Your teaching plan should include information needed for the administration of insulin.

Answer 1

The teaching plan will include the following information:

1. You must understand the dose of insulin prescribed by the doctor
2. The dosing differs based on the type of insulin used, plain/ Lente or mixtard
3. Basal bolus doing is the common method employed.
4. In this method, the patient has to take on two types of insulin: regular/rapid and long/intermediate-acting
5. The rapid/ regular meal is taken 10 min prior to meals. Therefore, it is to be taken for 3 times a day ( before breakfast - before lunch - before dinner)
6. The bolus insulin is administered to take care of the postprandial spike in the patient's blood sugars
7. Basal dose is administered to take care of fasting hyperglycemia. The basal dose of insulin is administered 2 times a day ( morning/ night) incase of intermediate-acting insulin. If long-acting insulin-like detemir is used then once a day done is enough
8. the instruction for insulin administration are
   1. It is always a good idea to measure your blood glucose levels before injecting insulin
   2. Fill up the insulin injection with the prescribed dose of insulin
   3. Site of injection - abdominal fat of fat
   4. clean the injection site with spirit
   5. Pinch a good amount of  abdominal fat with the help of thumb and index fingers.
   6. Then inject the insulin inject at an angle of 45 degrees to the surface of the skin
   7. This ensures that the medicine is administered subcutaneously.
   8. Push the piston of the injection until the injection is empty.
   9. Remove the injection from the abdomen and discard it.
   10. If you have injected yourself with rapid-acting insulins (aspart) have food within 15-20 mins to prevent hypoglycemia.
9. If you feel giddy, start sweating and lose focus then you probably are suffering from hypoglycemia - in such a case
   1. eat a toffy, candy or glucose water, biscuit (15g of glucose should enter your body
   2. don't take the next insulin dose,
   3. Visit your diabetologist if these events are occurring repeatedly.