NURS 6521 DIABETES AND DRUG TREATMENTS

Walden University NURS 6521 DIABETES AND DRUG TREATMENTS – Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6521 DIABETES AND DRUG TREATMENTS  assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6521 DIABETES AND DRUG TREATMENTS 

Whether one passes or fails an academic assignment such as the Walden University NURS 6521 DIABETES AND DRUG TREATMENTS  depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 6521 DIABETES AND DRUG TREATMENTS 

The introduction for the Walden University NURS 6521 DIABETES AND DRUG TREATMENTS  is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 6521 DIABETES AND DRUG TREATMENTS 

After the introduction, move into the main part of the NURS 6521 DIABETES AND DRUG TREATMENTS  assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6521 DIABETES AND DRUG TREATMENTS 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6521 DIABETES AND DRUG TREATMENTS 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6521 DIABETES AND DRUG TREATMENTS

Introduction 

Diabetes is primarily a disorder of carbohydrate metabolism that also disrupts protein and lipid metabolism as a result of a defect in insulin secretion, insulin action, or both. It is characterized by sustained hyperglycemia that leads to polyuria, polydipsia, ketonuria, and weight loss (Rosenthal & Burchum, 2021). 

Classification of Diabetes 

Diabetes is classified into type 1 diabetes mellitus, type 2 diabetes mellitus, gestational diabetes, and juvenile diabetes. Type 1 diabetes is due to autoimmune beta cell destruction, usually leading to absolute insulin deficiency. Gestational diabetes is any degree of glucose intolerance that is first recognized during pregnancy and may persist after pregnancy (American Diabetes Association, 2019). Juvenile diabetes is type 1 diabetes commonly seen in children and adolescents. The incident rate increases from birth and peak between 10-14years (Bimstein, Zangen, Abedrahim, &Katz, 2019). 

Type 2 diabetes accounts for 90-95% of all diabetes. It is as a result of relative insulin deficiency and insulin resistance. Patients with type 2 diabetes are capable of insulin synthesis but the liver, muscles and adipose tissue exhibits insulin resistance because the cells are less able to take up and metabolize the glucose available to them. The risk of developing type 2 diabetes increases with age, obesity, and lack of physical activity. Type 2 diabetes is associated with a strong genetic predisposition. It occurs more in certain racial and ethnic subgroups such as African American, American India, Hispanic/Latino, and Asian American (American Diabetes Association, 2018). 

Drug Used for Type 2 Diabetes 

Metformin classified as biguanide is the drug of choice for initial treatment of type 2 diabetes in combination with a reduced-calorie diet and exercise. Metformin increases glucose uptake by inhibiting glucose production in the liver, reduces glucose absorption in the gut, and sensitizes insulin receptors in target tissues. Metformin is effective, safe, inexpensive, and may reduce the risk of cardiovascular events and death. It can be used alone or in combination with other drugs. Common side effects are decreased appetite, nausea, and diarrhea. The dose is titrated to minimize the severity of gastrointestinal side effects (American Diabetes Association, 2018). 

Metformin is available as immediately released tablets, extended-release tablets, and an oral solution. The recommended initial dose for immediate-release tablets and oral solution is 500mg twice or 850mg once daily taken with meals. The extended-release tablets are taken once daily with the evening meal to enhance absorption due to gastrointestinal transit time at night (Rosenthal & Burchum, 2021). 

Impact of Type 2 Diabetes and Drug Therapy on Patients 

Acute life-threatening consequences of type 2 diabetes are hypoglycemia and nonketotic hyperosmolar syndrome. Long term complications include retinopathy with a potential loss of vision, nephropathy leading to renal failure, peripheral neuropathy with risk of foot ulcers and amputation, impotence, heart disease, and stroke (American Diabetes Association, 2019). 

Metformin leads to vitamin B12 and folic acid deficiencies. Vitamin B12 deficiency can contribute to peripheral neuropathy. Also, severe lactic acidosis can occur in patients with significant renal impairment due to the accumulation of metformin (Rosenthal & Burchum, 2021) 

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  References 

American Diabetes Association. (2018). Pharmacologic approaches to glycemic treatment:  

Standards of medical care in diabetes-2018. Diabetes care,41(Suppl.1, S73-S85. doi:10.2337/dc18.S008. Retrieved from https://care.diabetesjournals.org/content/diacare/41/supplement_1/S73.full.pdf. 

American Diabetes Association. (2019). Classification and diagnosis of diabetes: Standards of  

medical care in diabetes-2019. Diabetes Care, 42(Suppl.1), S13-S28. doi:10.2337/dc19.S002. Retrieved from https://care.diabetesjournals.org/content/42/Supplement_1/S13 

Bimstein, E., Zangen, D., Abedrahim, W., & Katz, J. (2019). Type 1 diabetes mellitus (juvenile  

diabetes): A review of pediatric oral health provider. The journal of clinical pediatric Dentistry, 43(6),417-423. doi:10.17796/1053-4625-43.6.10. Retrieved from https://www.proquest-com.ezp.waldenulibrary.org/docview/2330603107?accountid=14872 

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice 

Sample Answer 2 for NURS 6521 DIABETES AND DRUG TREATMENTS

Diabetes is a metabolic disorder that affects many people as they age. This condition occurs due to a lack of insulin secretion by pancreatic beta cells or insulin-sensitive tissues’ inability to react to the hormone properly (Galicia-Garcia et al., 2020). Glycosylated hemoglobin (HbA1C) values, fasting plasma blood sugar (FPG) levels, and 2-hour plasma blood sugar levels during oral glucose tolerance testing are used to diagnose Diabetes Mellitus in adults and children. 

There are 3 types of diabetes, Type 1, Type 2, and gestational diabetes. 

Diabetes Type 1, also known as juvenile diabetes affects during childhood between ages 4-14. Compared to healthy individuals, type 1 diabetics have decreased beta-cell function (DiMeglio et al., 2018). Symptoms of this condition include typical high blood sugar, weight loss, excessive urination, and thirst.  

Diabetes Type 2, is the most common diabetes prevalent today. This type of diabetes occurs due to advanced age, a sedentary lifestyle, obesity, and a lack of a proper diet and healthy lifestyle. High blood sugar is a symptom of diabetes type 2 when the body is unable to create enough insulin, use enough insulin, or properly utilize glucose as an energy source. The prevalence of T2DM is influenced by a variety of genetic, metabolic, and environmental risk factors that interact with each other (Galicia-Garcia et al., 2020). 

Gestational diabetes usually develops during pregnancy that does not already have diabetes. Managing this condition will result in healthy and safe pregnancy and a healthy baby. Increased rates of gestational diabetes mellitus (GDM) and related pregnancy and postnatal problems are a result of increased obesity (Lende & Rijhsinghani, 2020). Therefore, maintaining a healthy weight before pregnancy is crucial. Other factors that include gestational diabetes are advanced age, family history and ethnicity. 

Metformin belongs to a  drug class called biguanides. It is a drug of choice for diabetes type 2. This drug needs to start immediately upon diagnosing of diabetes to prevent further complications. Metformin tends to inhibit glucose production in the liver, and it also reduces glucose absorption in the gut. It is available in 500 mg, 850 mg, and 1000 mg tablets, some of which are Intermediate releases (IR) and others are extended-release tablets (ER). Because absorption takes time, IR tablets are usually given in doses of 500 mg twice daily, whereas ER tablets are given once daily in the evening. Patients with renal impairment can develop lactic acidosis when taking metformin; monitoring renal function and GFR is therefore vital. Patients with renal dysfunction must be aware of the signs and symptoms of lactic acidosis. Along with medication regimen, dietary restriction is just as important. 

Diabetes is managed using a combination of treatments rather than just one. High-fat meals should be avoided, as the fast can often get stored as glucose. High-sugar foods such as sweets, candies, and cakes also lead to diabetes and need to be avoided to control glucose levels. Exercise also helps use up the stored glucose for energy, lowering blood sugar levels. 

The short-term impact of diabetes type 2 is hypoglycemia and Hyperosmolar hyperglycemic nonketotic syndrome (HHNS). HHNS is a serious condition that results in high blood sugar levels. This causes frequent urination as the kidneys are working hard, leading to dehydration. Elevated heart rate, confusion, and fatigue are possible as well. The most common and frequently treatment-limiting side effect of diabetic treatment is iatrogenic hypoglycemia, which can result from glucose-lowering medication (Silbert et al., 2018). Not eating as much and being on a diabetic medication regimen also lead to hypoglycemia; hence, eating at certain times is crucial when taking insulin or medication. The long-term impact of diabetes leads to diabetic neuropathy, retinopathy, and cardiovascular disease. Though metformin effectively manages diabetes, long-term use can result in vitamin B12 deficiency. Hence, monitoring these deficiencies on a routine basis is important as well. 

DiMeglio, L. A., Evans-Molina, C., & Oram, R. A. (2018, June 16). Type 1 diabetes. Lancet (London, England). Retrieved December 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6661119/ 

Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K. B., Ostolaza, H., & Martín, C. (2020, August 30). Pathophysiology of type 2 diabetes mellitus. International journal of molecular sciences. Retrieved December 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503727/ 

Lende, M., & Rijhsinghani, A. (2020, December 21). Gestational diabetes: Overview with emphasis on medical management. International journal of environmental research and public health. Retrieved December 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767324/ 

Silbert, R., Salcido-Montenegro, A., Rodriguez-Gutierrez, R., Katabi, A., & McCoy, R. G. (2018, June 21). Hypoglycemia among patients with type 2 diabetes: Epidemiology, Risk Factors, and prevention strategies. Current diabetes reports. Retrieved December 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117835/ 

Sample Answer 3 for NURS 6521 DIABETES AND DRUG TREATMENTS

 I agree with you that lack of insulin secretion causes diabetes. Diabetic people have complication with their blood sugar levels. Besides, different people are prone to this metabolic disorder. There are 3 types of diabetes, Type 1, Type 2, and gestational diabetes. Different types of diabetes have unique signs and symptoms (Guo et al., 2020).  Some symptoms may not be easily noticed until there is screening. Both children and adults are vulnerable to diabetes mellitus.  However, Diabetes Type 1 alias juvenile diabetes affects during childhood between ages 4-14. Therefore, the metabolic disorder is not restricted to particular age group. Symptoms of diabetes type 1 include typical high blood sugar, weight loss, excessive urination, and thirst (Fleming et al., 2020). However, other symptoms have been unnoticed. As a result, regular screening becomes necessary for people prone to any type of diabetes. Advanced age, a sedentary lifestyle, obesity, and a lack of a proper diet and healthy lifestyle expose people to Diabetes Type 2.  The condition is common among most people suffering from diabetes.  

References 

Fleming, G. A., Petrie, J. R., Bergenstal, R. M., Holl, R. W., Peters, A. L., & Heinemann, L. (2020). Diabetes digital app technology: benefits, challenges, and recommendations. A consensus report by the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) Diabetes Technology Working Group. Diabetes care, 43(1), 250-260. https://doi.org/10.2337/dci19-0062 

Guo, W., Li, M., Dong, Y., Zhou, H., Zhang, Z., Tian, C., … & Hu, D. (2020). Diabetes is a risk factor for the progression and prognosis of COVID‐19. Diabetes/metabolism research and reviews, 36(7), e3319. https://doi.org/10.1002/dmrr.3319 

Sample Answer 4 for NURS 6521 DIABETES AND DRUG TREATMENTS

Diabetes Mellitus 

Introduction 

Diabetes Mellitus is a chronic condition that includes Type 1, Type 2, Gestational, and Juvenile Diabetes. Each of these diseases has similarities and differences. Type 1 Diabetes differs in diagnosis criteria, treatment, and drug therapy. There are specific dietary restrictions and impacts of long-term management of this disease. 

Differences in Diabetes Mellitus Types 

Type 1 Diabetes is characterized by cellular-mediated autoimmune destruction of pancreatic beta cells resulting in little to no insulin secretion and insulin dependency (Huether et al., 2020). Peak onset is at age 12 but can be diagnosed up to age 30.  Type 1 Diabetes is also known as Insulin Dependent Diabetes Mellitus (IDDM), and Juvenile Diabetes is now known as Type 1 Diabetes. Type 2 diabetes is characterized by insulin resistance and gradual insulin deficiency, with onset after age 40. It is commonly associated with obesity, specifically in the abdomen. Patients with Type 2 Diabetes can require insulin but are not insulin dependent. Gestational Diabetes is defined as any degree of glucose intolerance with onset or first recognition during pregnancy (Huether et al., 2020) 

Type 1 Diabetes-Drug Therapy 

Immune destruction of the beta cells in the pancreatic islets causes an absolute deficiency of insulin, requiring life-long insulin replacement (Lucier & Weinstock, 2022) IDDM can be treated with various types of insulin, short-acting, intermediate, and long-acting. Long-acting insulin, such as Lantus, provides a basal rate of insulin over a 24-hour period. Short-acting insulin, such as Lispro, can be used in an insulin pump or by daily subcutaneous injections. Lispro acts quickly, with peak effects within 30 minutes and a duration of action of up to 5 hours. Lispro works rapidly because modification results in insulin molecules becoming less likely to aggregate, leading to faster absorption and action. All insulins, including Lispro, are susceptible to degradation in the GI tract; therefore, subcutaneous or intravenous administration is required. 

Preparation and Administration 

Preparation of Lispro includes inspecting the vial or pen visually before use, as it should only be used if it appears clear and colorless. Opened (in-use) vials/pens should be stored between 2-8°C or below 30°C for up to 28 days, cannot be frozen, and need to be protected from heat and light (Heise et al., 2022). Administration can be subcutaneous via injection or insulin pump. Dosage is individualized and adjusted according to the patient’s metabolic requirement, blood glucose level, and glycemic control goal (Heise et al., 2022) Lispro should be administered 15 minutes before a meal or right after a meal due to rapid onset. Patient education should include blood sugar readings that indicate Lispro should be held to reduce the risk of hypoglycemia. 

Dietary Consideration and Impacts 

  When possible, patients should be taught carbohydrate counting and instructed to use an insulin-to-carbohydrate ratio that approximates the grams of carbohydrates that will be covered by one unit of insulin and a carbohydrate consistent diet (Lucier & Weinstock, 2022) Lispro should be taken 15 minutes prior to a meal or directly after a meal to decrease the risk of hypoglycemia. The most common short-term effect of IDDM is the risk of diabetic ketoacidosis and hypoglycemia, which can occur with poor control. Long-term effects of IDDM include skin disorders, dental problems, retinopathy, macular edema, neuropathy, kidney disease, cardiovascular disease, peripheral arterial disease, stroke, and foot ulcers (Lucier & Weinstock, 2022). Long-term effects of Lispro include depression, seizures, excessive hunger, and numbness and tingling in the hands and feet.   

References 

Heise, T., MD, Piras de Oliveria, C., MD, Juneja, R., MD, Ribeiro, A., MD, Chigusta, F., MPH, & Blevins, T., MD. (2022). What is the value of faster acting prandial insulin? Focus on ultra rapid lispro. Diabetes, Obesity, and Metabolism, 24(9), 1689–1701. https://dom-pubs.onlinelibrary.wiley.com/doi/full/10.1111/dom.14773Links to an external site. 

Huether, S. E., McCance, K. L., & Brashers, V. L. (2020). Understanding Pathophysiology (5th ed.). Elsevier. 

Lucier, J., & Weinstock, R. S. (2022). StatPearls. Treasure Island. https://www.ncbi.nlm.nih.gov/books/NBK507713 

Sample Answer 5 for NURS 6521 DIABETES AND DRUG TREATMENTS

LISA I agree with you that Type 1, Type 2, Gestational, and Juvenile Diabetes have similarities and differences. Therefore, treating these different types of diabetes may require unique approach. Type 1 Diabetes differs in diagnosis criteria, treatment, and drug therapy. Identifying the exact condition is important in guiding the treatment process. Regular screening is important in identifying the type of diabetes (Hill-Briggs et al., 2021).  Unfortunately, some people fail to undergo screening. As a result, medication errors may interfere with the intervention efforts.  Type 1 Diabetes is also known as Insulin Dependent Diabetes Mellitus (IDDM), and Juvenile Diabetes is now known as Type 1 Diabetes (Cole & Florez, 2020). Type 2 has distinct signs and symptoms.  The condition is characterized with insulin resistance and gradual insulin deficiency, with onset after age 40. Frequently, wrong lifestyle choices are attributed to causing Type 2 Diabetes. Therefore, maintaining healthy eating habits and regular physical exercise limits the chances of contracting Type 2 Diabetes. Medical intervention is also resourceful in assisting patients of different types of diabetes.  

References 

Cole, J. B., & Florez, J. C. (2020). Genetics of diabetes mellitus and diabetes complications. Nature reviews nephrology, 16(7), 377-390. 

Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., … & Haire-Joshu, D. (2021). Social determinants of health and diabetes: a scientific review. Diabetes care, 44(1), 258-279. https://doi.org/10.2337/dci20-0053 

Sample Answer 6 for NURS 6521 DIABETES AND DRUG TREATMENTS

In this week’s discussion, we are to reflect on differences between types of diabetes. Then, we are to select one type of diabetes to focus on and consider one type of drug used to treat the type of diabetes we selected including proper preparation and administration of this drug.  Then we are to reflect on dietary considerations related to treatment.  Finally, we are to think about the short-term and long-term impact of the diabetes selected, including effects of drug treatments.  Type I diabetes (or juvenile diabetes) is the most common pediatric disease and is usually diagnosed from infancy to the late 30’s (McCance & Huether, 2019). There are two types:  Autoimmune and Nonautoimmune.  In this type of diabetes, a beta cells in the pancreas are destroyed.  Symptoms for diagnosis are polydipsia,  polyuria, polyphagia, weight loss, and hyperglycemia, and intermittent DKA.  The patient is insulin dependent.

Type II diabetes usually affects those people over 40.  Insulin resistance and obesity is associated with type II diabetes.  The pancreas cannot use the insulin produced properly, and there is a reduction in beta cell mass and function (McCance & Huether, 2019).  The cells become resistant to insulin, making an excess of insulin than is necessary to keep blood glucose levels within a normal range.  The symptoms are obesity, dyslipidemia, and hypertension.  The patient experiences polyuria and polydipsia.  There are also recurrent infections, genital pruritus, visual changes, paresthesia, fatigue, and acanthosis nigricans.   The patient is not usually insulin dependent, but may require insulin.

Gestational diabetes occurs during pregnancy.  There is insulin resistance and inadequate insulin secretion.  It is most likely to occur in women who are obese, 25-years-old, have a family history of diabetes, have a history of gestational diabetes, or are of Native American, Asian, or black (these ethnic groups have a higher incidence rate of gestational diabetes (McCance & Huether).

For this discussion I am focusing on type II diabetes mellitus.  Those with this type of diabetes have a mortality rate twice that of the general population.  Complications from this type of diabetes are myocardial infarction, stroke, nephropathy, retinopathy, and peripheral arterial disease and neuropathy resulting in amputation (Laursen et. al., 2017).  One of the drugs used to treat this type of diabetes is in a class of drugs called biguanide named Metformin.  This drug decreases glucose production by the liver, reduces glucose absorption in the gut, and sensitizes insulin receptors in fat and skeletal muscle.  Metformin is slowly absorbed from the small intestine, and is excreted unchanged by the kidneys.  If there is renal impairment, it can produce toxic levels (Rosenthal  & Burchum, 2021).  It can be used alone, or with insulin.  Importantly,  it can be used for patients who skip meals because it does not lower blood glucose.  It can be taken during pregnancy. 

Common side effects are decreased appetite, nausea, and diarrhea.  Metformin decreases absorption of vitamin B12 and folic acid, thus causing vitamin B and folic acid deficiencies.  It does not cause weight gain.  It is important to eat healthy meals while taking Metformin, and not skip meals.  Metformin can cause lactic acidosis.   Initial dosing is immediate release 850-1000 mg daily or extended release 500 mg nightly.

 References

Laursen, D., Christenssen, K., Christensen, U., & Frolich, A. (2017). Assessment of short and long-term outcomes of diabetes patient education using the health education impact questionnare (HeiQ). BMC Research Notes 10(213).  https://doi10.1186/s13104-017-2536-6 

McCance, L.L. & Huether, S.E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8^th ed.). St. Louis, MO: Mosby/Elsevier. 

Rosenthal, L.D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

Types of Diabetes

Diabetes is an autoimmune disease that affects how the body processes energy production. It is characterized by abnormal insulin production and impaired insulin utilization (American Diabetes Association., 2018). There are several types of diabetes with unique treatment and characteristics. There are type 1 diabetes, type 2 diabetes, gestational diabetes, and juvenile diabetes.

Type 1 diabetes is an autoimmune condition where the body’s immune system affects the beta cells, which are the core producers of insulin in the islets cells of Langerhans. The body produces insufficient insulin, primarily diagnosed in young adults and children (Rosenthal et al., 2021). Type 2 diabetes is the most common, characterized by insulin resistance. This condition is often associated with older people who present with obesity, physical inactivity, and a family history of diabetes. It is more common in certain ethnicities, such as African American. Gestational diabetes develops in women during pregnancy. It resolves after the baby is born. Gestational diabetes increases the risk of the mother developing type 2 diabetes. Juvenile diabetes is another term for type 1 diabetes because it is diagnosed in children and young adults.

The primary treatment for type one diabetes is insulin administration. Insulin replaces a hormone that the body does not produce. A variety of insulin hormones are administered through injections or insulin pumps. Insulin preparation is through the insertion of human insulin protein into a plasmid. The bacteria are allowed to multiply, producing large quantities of insulin genes. They are packaged into insulin pens and vials. Insulin injections are the most common method. It is injected into the thighs, upper arms, and buttocks. Insulin pens have needles at the end; they are pre-filled and dialed the correct amount. The insulin pumps are worn on the body. They deliver insulin by catheter under the skin. The inhaled insulin can be breathed when necessary.

According to the American Diabetes Association (2018), there is rapid-acting insulin, which has an onset of 15 minutes and lasts for an approximation of five hours; the short-acting is active within thirty minutes and lasts for around eight hours; the intermediate-acting peaks from three hours and last for approximately sixteen hours. The long-acting insulin activates after one hour and lasts for one day.

Diabetic type 1 is controlled through a properly balanced diet—physical activity, and control of blood glucose levels. There must be proper carbohydrate counting, which has the most significant impact on blood sugars. The patient should be measured for glycemic index. Type 1 can be controlled by low GI foods such as whole grains, fruits, vegetables, and legumes. Healthy fats from nuts, fish, and avocados should be used. The high-fiber food can be used to absorb sugar into the bloodstream. Regular meal times stabilize blood sugar; skipping meals can lead to unpredictable blood sugars.

In the short-term impact, diabetic type 1 leads to hyperglycemia, tiredness, raised pulse rates, and general body malaise. This short-term impact needs to be responded to promptly with appropriate management. The long-term consequences can progress to heart disease, end-stage kidney failure, nerve damage, and eye vision disturbances.

Insulin, as the regime treatment for type 1 diabetes, manages the blood sugar levels and reduces the risks of complications. However, this management requires strict adherence as it can cause hypoglycemia.

References

American Diabetes Association. (2018). pharmacologic approaches to glycemic treatment: standards of medical care in diabetes—2018. (2017). Diabetes Care, 41(Supplement_1). https://doi.org/10.2337/dc18-s008

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

Ethical and Legal Implications of Prescribing Drugs NURS 6521

Ethical and Legal Implications of Prescribing Drugs 

When a patient enters the health center, medication is very likely to be administered. A health history and a patient’s medical evaluation are important things to examine when administering medication. A nurse or doctor should administer the care of the condition and be informed of the standard a condition should be offered depending on a background of health and physical inspection​ (Rosenthal & Burchum, 2020)​. In this discussion, the essay focuses on Scenario 2 to clarify the ethical and legal ramifications of patient family, prescriber, pharmacist and patient to all parties concerned. The discussion continues by explaining the methods I will use to drive decision-making for an experienced clinical nurse in the selected scenario. 

Selected scenario 

A colleague calls and demands for drugs to be taken for her. You are self-sufficient, but do not have the medical experience of your mate. Anyway, you write the drug.  The ethical, as well as legal implications of the scenario on all stakeholders such as the prescriber, pharmacist, patient, and patient’s family, discuss as follow: 

Nurse Practitioner: A nurse who uses medications without performing the requisite testing, evaluation and legal consequences such as absence, as needed by the medical code of ethics, such as the Colorado “Medical Practice Act,” breaches the code and is unprofessional​ (Sabatino & Pruchnicki, 2017)​. The NP who prescribes medication for a friend without a medical background fears jeopardizing his permit since adverse reactions can turn fatal. A nurse has the ethical obligation to prescribe the best medication, but only after a medical exam and evaluation. 

Pharmacist:  In mediation, a pharmacy dealer who carries out a prescription does not presume that the prescriber has made an examination, nor that the practitioner is ethically and legitimately liable for the background before the order is submitted. Thus, loading the Rx with the pharmacist’s chance of losing the license while knowing his clinical background. 

Patient and family: Prescribing drugs to a patient is morally and technically permissible whether a patient may not have an awareness of his or her background, evaluation and allergies. Therefore the patient and the relatives will bring court charges against the nurse and pharmacy firm should any incident take place. 

Strategies to Guide Decision making  

The first strategy is to call the patient before prescribing medication and to make an appropriate date for a medical evaluation to reach the condition. Medical testing and an assessment may lead to the patient’s medical condition and, therefore, to the required medication​ (Musellim & Borekci, 2017)​.   In medical and personal interactions, faulty and incorrect prescribe inaccurate medications, less frequent usage for preventive treatment, loss of medical satisfactions, and escalated aggressive incidents against healthcare providers, maybe the result of a patient’s evaluation over a short duration of time. The patient assessment period could have been influenced too gradually or too rapidly. 

The second strategy is to do the clinical examination before administering medication to assess the condition of the patient. Clinical trials are study experiments in which patients actively undergo experimental therapeutic techniques, techniques or measures in order to avoid, diagnose, cure or control various conditions or diseases​ (Rosenthal & Burchum, 2020)​. Some studies consider how people react to a new procedure and what side effects may be created. The third method is to implement a prescriptive decision-making process by looking at the patient’s family members and their prior fitness. The prescriptive method of educated judgment aid approaches describes a variety of strategies to enable citizens to think differently about a decision. 

Process of Writing Prescriptions 

There are important things that physicians should consider before writing medications. Relevant elements must also be considered. Again, it is necessary to remember that there are norms in various countries. The criteria specify that the details on medications are provided. Both medications usually tend to use a vocabulary the consumer can understand such that they can learn quickly how to take medicine. Secondly, it is important to write clearly in writing while writing the medication​ (Solanki & Shah, 2015)​. Third, it is necessary to determine the duration of usage of the medication and the days the patient is supposed to take. Additional detail used is subject to local drug laws. With the exponential advancement of technology, electronic prescribing will continue to reduce the cost-effectiveness of drug mistakes. Electronic prescribing is an efficient means of eliminating medication errors. The continuous dependency on handwriting writing is one of the factors that have made medication mistakes inevitable​ (Nickless & Davies, 2016)​. Handwritten prescriptions might be negligible. Problems like this can be overcome by technology-based prescribing, as this will help to reduce drug mistakes. 

​​References 

​​Musellim, B., & Borekci, S. (2017). What should be the appropriate minimal duration for patient examination and evaluation in pulmonary outpatient clinics? Annals of Thoracic Medicine, 12(3), 177–182. doi:10.4103/atm.ATM_396_16 

​Nickless, G., & Davies, R. (2016). How to take an accurate and detailed medication history. The Pharmaceutical Journal. 

​Rosenthal, L., & Burchum, J. (2020). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants. Elsevier – Health Sciences Division. 

​Sabatino, J. A., & Pruchnicki, M. C. (2017). Improving prescribing practices: A pharmacist-led educational intervention for nurse practitioner students. Journal of the American Association of Nurse Practitioners, 29(5), 248-254. doi:10.1002/2327-6924.12446 

​Solanki, N. D., & Shah, C. (2015). Prescription audit in outpatient department of multispecialty hospital in western India: an observational study. International Journal of Clinical Trials, 14-19. 

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