Question

your patient is 33 years old and as been diagnosedwith type 1 insulin dependent diabetes mellitus. she is going to require two injections of insulin, one in the morning and one in the evening, with both rapid and intermediate acting insulins.                          .    
1. based on the use of nursing diagnoses, is it acceptable to formulate nursing diagnoses for medication related issues,? explain your answer                2. the patient, who has never had the experience of self administering an injection, requires a subcutaneous injection twice daily. develop a nursing diagnosis for the patient that focuses on the newness of the treatment regimen.                                     3. what would be evaluated with drug administration? 4. develop a goal and outcome criteria for the patient. make sure that they relate to one of the nursing diagnoses that focus on the drug therapy .Also include what would be monitored by during the evaluation phase or the nursing process for specific diagnosis, goal,and outcomes criteria you develop.     5. the patient has developed some problems with absorption of subcutaneous insulin . her blood glucose readings vary tremendously during the course of a 24 hour period, with periods of hyperglycemia. she has been laid off work, has financial difficulties, and has found that she needs new glasses for her progressive loss in close up vision. Develop two nursing diagnoses that would be appropriate for this patient as related to drug therapy and the nursing process and the specific information presented in this question.

Answer 1

1.All medications tends to give side effects irrespective of how low the dose or how costlier it is.It is possible to form nursing diagnosis on drug related issues.The main action of insulin is to control blood glucose so there is always a chance for decrease in blood sugar ,injection is a painful process though it is a very smallest and fine needles used ,it can damage the muscular system overtime

• Risk for hypoglycemia related to insulin therapy (can be evidenced by dizziness ,extreme low blood sugar level)
• Lipodystrophy related to daily injection or pricking (can be evidenced by hard skin at the injection site)

2.Deficient knowledge related to insulin therapy,techniques,treatment regimen as evidenced by confused face,anxiety

3.The following things has to be evaluated before administration of insulin

• Monitor the blood glucose level periodically
• Assess for any complaints of dizziness
• Is patient using any OTC medication
• C peptide test before starting insulin (this determines whether insulin is needed or not)

4.Risk for hypoglycemia related to insulin

Goal/outcome :to maintain blood sugar in normal range and prevent hypoglycemia

Nursing intervention

• Educate about the action of insulin, this helps the patient to be aware of the medication effects
• Regularly monitor the blood glucose level ,to prevent hypoglycemia
• Encourage patient to administer insulin before food and should eat food with in 30 minutes of insulin administration
• Not to skip meals,because this can cause extreme low sugar
• Not to take any herbal supplements without providers consultation becaus this can interact with the insulin absorption

Evaluation

• Blood glucose will be maintained in normal ranges