Case Study 2

Assignment Content
During the Skills Laboratory your instructor may ask you to complete clinical cases and worksheets. You instructor will advise you whether you will be submitting them in class or via drop box. If it is by drop box:
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Assignments:
Readings: Review Unit XV, Chap #47 Endocrine Insulin Administration (McCuistion, 2018)
Topic: Mixing Insulin.
Please review the following Case Study. Your assignment is to describe the correct way that you as the nurse would administer this patient’s insulin. Be specific with dosages as ordered in the case study. No need to site any references.
Include the following information as if you were given the order and had to demonstrate this to your instructor all the steps needed to adm this insulin to the patient.. Consider the following components:

how you greet the patient
Include 6 Rights
any preparation, Including hygiene, safety and technique, Identify the appropriate syringe and needle
Correctly describe the order and procedure for mixing the insulin
List any assessments that are appropriate before and after administering the insulin
Describe the Correct technique for administration of insulin, include location
Discuss any patient teaching appropriate for this patient

Do not reprint the checklist. I want you to show me how you would do every step in a written format.
Total points 10. 
Case:
Mr Eduardo Alvarez is a 64 y/o male who was adm to the hospital with new onset DM, hyperglycemia. His BG in the Emergency Department was 800. Pt was lethargic and dehydrated. Initially pt was place on an insulin gtt. 
PMH: HTN, has not seen a doctor in 1 yr. He admits that he has put on 50 # in the past 6 months. c/o feeling very fatigued. He tells you that over the past month,. He urinates very frequently in large amounts, He drinks a quart of OJ a week, and Dr Pepper at least 3-4 cans a day.
Social hx: Non smoker, married, works 8-10 hrs day and goes to school 3 nights a week to study business.
Surgical hx; neg
FH: Mother DM Type II on Insulin, F ather: HTN
Home meds: Lisinopril 20 mg qd
Now his BG has come down to and average <250. WEight 306#. BP 128/72, HR 78, RR 18, T 97.4, 02 Sat 98%. The provider discontinues the Insulin gtt and pt is started on Insulin. The order reads NPH 30 U and Humalog insulin 6 units q 12. Accuhecks QID AC and at HS You are Mr Allen's nurse on the day shift, This is day 2 of Injectable Insulin off the Insulin pump