Insulin Injection
Insulin injection is a hormone used to boost body cells to utilize glucose for energy because it balances the glucose levels in an individual’s body. When there is excess glucose in a person’s body, insulin activates the body to store the surplus glucose in the liver (van Niekerk et al.,2020, p. 36). An individual’s sugar levels may increase between meals, when they are depressed, or when their bodies require additional energy. Insulin augments sugar to move from the bloodstream to the body cells (Karigire, 2019, p. 243). An individual’s body may fail to produce insulin to regulate glucose or produce insulin but fail to use it appropriately. When the body fails to utilize insulin correctly, the pancreas fails to produce enough insulin (Kim and Park, 2017, p. 145). Diabetes is usually controlled with diet, exercising, medications, including supplementing the body with insulin.
The condition of lipodystrophy causes fat to accumulate or break down under the skin, resulting in indentations or lumps that affect insulin absorption. Patients rotate different body sites when injecting insulin, including thighs, buttocks, arms, and abdomen. Rotation of injecting sites enhances individuals to avoid over-concentration on a single part, leading to pain and irritation (Jedlowski et al., 2019, p. 99). The abdomen is the most preferred part through which various individuals administer insulin. The abdomen allows the hormone to absorb quicker, and it is easier to reach the abdomen (Hövelmann et al., 2017, p. 503).
Patients select a site between the pubic area and under the rib, then inject two inches from their previous injection. Patients are advised to avoid blemishes, scars, and moles since they interfere with how the body absorbs them.
Demonstration on How to Use Insulin Injection
Before administering the hormone, patients are advised to check on the quality. For instance, insulin should be left to cool with the normal room temperature if stored in cool conditions. If it seems cloudy, patients should mix the contents by rubbing the vial between the hands for seconds (Bahendeka et al., 2019, p. 343). The vial should not be shaken; short-acting the hormone mixed with other insulin should not be cloudy. In addition, patients should avoid using condensed, grainy, or stained insulin. Moreover, patients are advised to be keen on any broken varicose veins’ insulin (Pandya, Losben and Moore, 2019, p. 139). Insulin is injected on an individual’s outer layer of the thighs, approximately four inches up from the knee and four inches’ top of the leg.
Steps
When patients independently administer the insulin injection, they assemble the supplies. They gather bandages, alcohol pads, gauze, puncture-resistant containers for appropriate disposal of used syringes and needles, syringes and needles, and medication vials (Kesavadev et al., 2020, p. 1267). Afterward, they wash their hands clean with warm water and soap. Patients are advised to observe hygiene standards before insulin administration. Patients should hold the syringe with a needle in an upright position, the needle pointing up (Oleck, Kassam and Goldman, 2016, p. 183). The patient then pulls the plunger downwards until its tip reaches the measure equivalent to their intended dosage.
Patients then remove the insulin needle and vial; if the vial has been used before, wipe clean the stopper with a wiper with an alcohol cloth. The needle is pushed into the stopper before pushing the plunger downwards, pushing air in the syringe to move to the bottle. The air is important because it replaces the hormone to be withdrawn. The needle is kept in the vial then kept upside down (Frid et al., 2016, p. 1240). The plunger is pulled downwards until the top of the plunger touches the dosage mark on the syringe. The syringe is tapped gently tapped to make bubbles move to the top. The syringe is pushed to discharge the bubbles into the vial. The plunger is then pulled down up to the correct dosage. The insulin vial is set down, and the syringe is held like a dart.
Skills of How to Calculate Daily Insulin Dose
High blood sugars contribute to worse results among hospitalized patients, and sliding scales regimens generate extra hypoglycemia and hyperglycemia. When hospitals shift from sliding scales to bolus and basal dosing, they apply three different techniques, depending on a patient’s history (Newsom et al., 2018, p.55). These methods are also applied depending on how the patient uses insulin as an outpatient or inpatient in the Intensive Care Unit (Golden et al., 2017, p. 15). When doctors transition ICU patients using “IV insulin” to “sub-Q insulin,” they take a patient’s usual hourly insulin brew rate over the last six hours (Adam et al., 2017, p. 272). Summing the insulin in a patient’s regimen, and using a patient’s diabetic status, body habitus, and weight determines their daily dose.
Recognizing the home regimen of a diabetic patient is important during establishing the patient’s daily dose. Patients with deprived control are given an additional 10% insulin injection in their daily dose (Beck et al., 2017, p. 367). Patients who are elderly, frail, sensitive to insulin, on hemodialysis, lean, or hypoglycemic risks are given 0.3units per kilogram daily (Umpierrez et al., 2019, p. 1307). Patients with normal weight are given 0.4 units per kilogram daily (Umpierrez et al., 2019, p. 1307). Overweight patients receive 0.5 units per kilogram daily, while obese, insulin-resistant patients or high steroid doses receive 0.6 units daily (Umpierrez et al., 2019, p. 1307). Patients transitioning from IV insulin and not on an insulin regimen may be given the daily insulin dose depending on their diabetic status, weight, and body habit.
Nurses accumulate the insulin the patient is taking and adjust the dose depending on the eating habit of the patient, illness severity, and usage of steroids, and the patient’s control levels at home. Nevertheless, when individuals get used to the sliding scale alone, even 0.6 units per kilogram daily to estimate their daily doses can make physicians suspicious (Umpierrez et al., 2019, p. 1307). As physicians and hospitals get more comfortable monitoring hyperglycemia among patients, initial doses become extra aggressive (Tatalovic et al., 2019, p. e028914). Nurses should often monitor how well the patient’s sugars were controlled in the ICU before giving the insulin injection.
Discussion
I would like the three of you to answer a few questions to know if you have understood what insulin injection is. This discussion will tell whether you are confident when administering the insulin injection. The first question goes to patient 1(the female); what is an insulin injection? (Other learners carefully listen to her answer). The next question is answered by member 2, a male participant; what is insulin injection used for? The third male participant also answers the third question; how is insulin injection administered? Thank you for answering correctly; now it is demonstration time. I will demonstrate how the injection is administered independently. Be attentive and keen because I will require each of you to demonstrate how the injection is administered at the end of the demonstration.
In our discussion, I will use the social learning theory to examine your (the three participants) learning behaviors and how well you (the three learners) have understood the topic. The theory assumes learners acquire new knowledge and behaviors through observations (O’Brien and Battista, 2020, p. 500). Professional health nurses facilitate operative health promotion designs by applying behavioral change theories. Preparing health promotion programs relying on the Social Learning Theory involves examining individuals and environmental elements that impact their behaviors (O’Brien and Battista, 2020, p. 500). Punishments and reinforcements indirectly impact an individual’s learning and behaviors; people create expectations concerning the potential impacts of future answers depending on how present replies are punished or reinforced.
Female learner 1, from our lesson, can you tell nurses’ roles in supporting the learning of service users and peer learners? Nurses support the learning of peer learners and service users by playing significant roles in facilitating learning, assisting students in growing as nurses, and evaluating students learning. Male participate 1 do you know any other function? Nurses also engage in formulating programs, operating as change leaders and agents, and engaging in activities that support learning, similar to how you have supported us to recognize how we should administer insulin without relying on third parties (Schonert-Reichl, 2017, p. 140). Male member 2, any additional role you know? Nurses also adjust their teaching techniques to fit patient expectations by using common phrases, audio, videos, and reading materials.
Thank you for your correct answers; various factors could hinder your learning how to administer insulin. When a learner does not often receive assessments on what they have mastered, the learner can end up accumulating deficiencies that interfere with their successful progress (Schonert-Reichl, 2017, p. 140). I want to assess the three of you to know what you have or have not mastered. Female student 1, can you tell us anything about the insulin injection? A nozzle is the utmost normally used in controlling insulin amid numerous individuals. Syringes differ depending on the size of the needle and the quantity of insulin they hold (Shah et al.,2016, p. 1). Most needles are constructed out of plastic, and are disposable after use.
Insulin injection is less painful, and patients should not fear when self-administering the injection. Male learner 1, how is insulin administered? The injection is administered hypodermically; into the fat layer beneath the skin. (Famulla et al., 2016, p. 1490; Bahendeka et al., 2019, p. 350). Third male learner, how is daily insulin dose calculated? Daily insulin dose is approximated using the base sum sub-Q dose on insulin infusion rates (Ainsworth, Shelley and Petróczi, 2018, p. 70). For the patients taking substantial food quantities, their insulin doses can be calculated using the sum of the general everyday dose (Bell et al., 2020, p. 62; Nikanjam et al.,2018, p. 2193; Bailey et al., 2018, p. 18). Once the patient starts taking meals, the rest of the dose is bolus volumes.
Before we go to the assessment stage, what else have you learned? (The learners will answer). “We have learned that the insulin injection boosts body cells to exploit glucose for dynamism because it stabilizes the glucose heights in a patient’s body. We should check the quality of the insulin hormone before we administer it to our body as advised by the doctor, and afterward, we should wash our hands”. Thank you for your positive feedback. I can see you were listening attentively. Now it is time for assessment to gauge your understanding.
Assessment
The three learners will participate in an assessment before the lesson ends. The assessment will include various questions inform of a questionnaire that the nurse teacher will give to the learners to know where they have understood or not. Some of the questions I will include in the questionnaire include; “is insulin a hormone? Does insulin cure diabetic patients? Do you know how to administer insulin injections without the help of a nurse? Do you have skills on how to calculate daily insulin doses? How is daily insulin dose calculated? What are the skills required when calculating daily insulin intake?” Upon successfully answering the questionnaires, the student nurse will examine the three participants’ knowledge of operating insulin pens, handwashing and discarding sharps correctly by observing the learners after the learning session.
Reference List
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