[Answered]: Skyler is a 23-year-old female returned to your ward…

Skyler is a 23-year-old female returned to your ward after undergoing a repair of a meniscus on her right knee after a long-term netball injury. She is alert and orientated and able to eat and drink post operatively. Skyler is a type 1 diabetic and requires insulin as follows: • Lantus 22 units subcutaneously at bedtime (nocte) • NoVo rapid 16 units subcutaneously before meals NOTE: If blood glucose is < 4 OR > 12mmol/L, contact the Medical Officer to adjust the dose. Task Skyler is due for her insulin NoVo rapid 16 units before dinner. It is 1800 and you have tested her blood glucose and it measures 4.6 mmol/L. This is within the normal range. Use the resources available in the simulation space to prepare and administer the medication to Skyler. Follow the Skill Assessment Marking Guide at the end of the workbook for a subcutaneous injection. Then answer the following questions in relation to Skyler’s medications. a) Identify the sites of administration for these injections: What are the landmarks you need to identify for these sites? b) Draw up the required volume in a syringe. What volume are you going to administer? 16 Units c) Ensure you have used the appropriate needle and syringe for this procedure. Explain the safety precautions required when drawing up this medication. d) Identify the correct administration technique for Skyler. What is the angle of the needle you need to use for insertion? e) How long do you expect it to take for Skyler to feel the effects of the medication? Task You notice from her chart that pre-admission Skyler normally takes Lantus at night. You decide to call Dr Bell and clarify if Skyler should be administered Lantus. Dr Bell thanks you for reminding him and tells you that Skylar is to have Lantus 22 units subcutaneously at 2200. What needs to happen for this to be a valid phone order? Practise writing this up as a phone order It is 21.45 and you retake Skylar’s blood glucose. It measures 6.0 mmol/L. Use the resources available in the simulation space to prepare and administer the medication to Skyler. Answer the following questions in relation to Skyler’s medication administration. a) Where are you going to administer this injection (which site) and why? How do you identify the landmarks for this site? b) Where are you going to administer this injection (which site) and why? How do you identify the landmarks for this site? c) Draw up the required volume in a syringe. What volume are you going to administer? d) Choose the appropriate size needle, describe the rationale for your choice. e) Administer the medication to Skyler using appropriate injection technique. What is this technique? f) How long do you expect it will take for Skyler to feel the effects of the medication? g) Are there other considerations in relation to this insulin injection? Assuming at 21.45 her blood glucose level was 3.8 mmol/L – would you have administered insulin? If not, what would you have done? Task Skyler complains of severe pain in her right knee. Use the resources available in the simulation space to prepare and administer the analgesia to Skyler. Follow the Skill Assessment Marking Guide at the end of the workbook for a subcutaneous injection. Complete the following tasks and answer the questions in relation to Skyler’s complaint. a) What assessments are required prior to administration of analgesia? b) From your assessment, review the medication chart for Skylar and identify the analgesia order. Is this medication indicated? Give a rationale for this choice? c) Morphine Sulphate 5mg/ml is ordered for Skyler. Identify the schedule of this drug and outline the nursing considerations required for its administration. d) Consult the injectables book. Is IM the preferred route? If not, can you go ahead and administer via another route? e) From your patient assessment, identify the landmarks for the appropriate administration site for Skyler. f) Draw up the required volume in a syringe. What volume are you going to administer? g) Choose the appropriate size needle, describe the rationale for your choice. h) Administer the Morphine Sulphate to Skyler using appropriate injection technique. i) How long do you expect it to take before Skyler feels the effects of the Morphine Sulphate? j) Are there other considerations in relation to Skylar’s IM injection? k) Discuss the side effects of this drug and any nursing implications.