diabetes mellitus

Module Report Tutorial: Module: Real Life RN Nursing Care of Children 3.0 Type 1 Diabetes Mellitus Individual Name: Institution: Program Type: April Granado West Coast U Anaheim BSN BSN Standard Us ...

Module Report Tutorial: Module: Real Life RN Nursing Care of Children 3.0 Type 1 Diabetes Mellitus Individual Name: Institution: Program Type: April Granado West Coast U Anaheim BSN BSN Standard Use Time and Score Date/Time Time Use Score Type 1 Diabetes Mellitus 10/24/2019 6:08:39 PM 5 min Strong Reasoning Scenario Performance Related to Outcomes: *See Score Explanation and Interpretation below for additional details. Body Function Strong Satisfactory Needs Improvement Cognition and Sensation 100% Integument 100% Regulation and Metabolism 100% NCLEX RN Strong Satisfactory Needs Improvement RN Psychosocial Integrity 100% RN Basic Care and Comfort 100% RN Pharmacological and Parenteral Therapies 100% RN Reduction of Risk Potential 100% RN Physiological Adaptation 100% QSEN Strong Satisfactory Needs Improvement Safety 100% Patient-Centered Care 100% Evidence Based Practice 100% Decision Log: Optimal Decision Scenario Nurse Tammy is further assessing Derek for manifestations of diabetes mellitus. Question Selected Ordering Rationale Optimal Decision Scenario Question Nurse Tammy is preparing to review the results of Derek’s urine dipstick. Which of the following results should Nurse Tammy expect as an indication of diabetes mellitus? Question Nurse Tammy is preparing to perform a fingerstick to check Derek’s blood glucose level. Identify the order in which Nurse Tammy should perform the following steps. (Reorder the steps by dragging them into the desired sequence.) Question Nurse Chris is determining the insulin dosage to administer to Derek. Prescribed is insulin 0.4 units/kg/day subcutaneous in four divided doses. Derek weighs 88 lb. Which of the following dosages should Nurse Chris plan to administer? Page 3 of 6 Question Nurse Chris is teaching Deborah and Derek about the hemoglobin A1c. Which of the following statements by Deborah indicates an understanding of the teaching? Selected Option Rationale Optimal Decision Scenario Question Nurse Chris is selecting a snack for Derek. Which of the following snacks should Nurse Chris choose? Question Nurse Chris is teaching Deborah about a fasting blood glucose test. Which of the following statements indicates Deborah’s understanding of the teaching? Selected Option "Derek’s fasting blood sugar level is expected to be between 70 to 110." Rationale Nurse Chris should confirm that Deborah’s statement is correct. Derek’s fasting blood glucose level is expected to be between 70 to 110 mg/dL. Optimal Decision Scenario Nurse Chris responds to Derek’s hypoglycemia. Question Nurse Chris is responding to Deborah’s report that Derek is tearful, irritable, and not acting like himself. Nurse Chris observes that Derek is diaphoretic. Which of the following actions should Nurse Chris take? Selected Option Give 4 oz orange juice. Rationale Nurse Chris should identify that Derek is exhibiting manifestations of hypoglycemia. Nurse Chris should check Derek’s blood glucose level and give him 10 to 15 grams of simple carbohydrate, such as 4 oz of orange juice, to increase his blood glucose level. She should then recheck his blood glucose level in 15 minutes. Optimal Decision Scenario Nurse Chris is teaching about insulin onset and peak times. Question Nurse Chris is teaching Deborah and Derek about insulin onset and peak times. Which of the following statements by Deborah indicates an understanding of the teaching? Selected Option "Regular insulin starts working within thirty minutes after injection." Rationale Nurse Chris should confirm that regular insulin begins working within 30 minutes following subcutaneous injection. Therefore, Derek will be at an increased risk for hypoglycemia at this time. Optimal Decision Scenario Nurse Chris is teaching about insulin injections/sites. Question Nurse Chris is teaching Derek and Deborah about injection site rotation and insulin injection techniques. Which of the following statements by Derek indicates an understanding of the teaching? Selected Option "I should inject the insulin straight in at a ninety-degree angle." Rationale Nurse Chris should confirm that Derek should inject the insulin at a ninety- degree angle into subcutaneous tissue. Optimal Decision Scenario Nurse Chris is teaching about insulin pens. Question Nurse Chris is teaching Deborah and Derek about insulin pens. Which of the following statements by Deborah indicates an understanding of the teaching? Selected Option "Derek should store the pen at room temperature once it’s been opened." Rationale Nurse Chris should confirm that an insulin pen that has been opened should be stored at room temperature and not refrigerated. Insulin should be given at room temperature to prevent subcutaneous tissue atrophy. Optimal Decision Scenario Nurse Chris is teaching Derek and Deborah about insulin pumps. Question Nurse Chris is teaching Derek and Deborah about insulin pumps. Which of the following statements by Derek indicates an understanding of the teaching? Selected Option "I would need to change the insulin pump needle about every two days." Rationale Nurse Chris should confirm that Derek would need to change the insulin pump needle and catheter approximately every two days to decrease the risk for infection. Optimal Decision Scenario Nurse Chris is teaching Derek and Deborah about sick days. Question Nurse Chris is teaching Derek and Deborah about diabetes management during illness. Which of the following statements by Deborah indicates an understanding of the teaching? Selected Option "Derek should check his blood glucose level every 3 hours when he’s sick." Rationale Nurse Chris should confirm that Derek should check his blood glucose level every 3 hours during an illness. Insulin dosages are determined based on blood glucose levels. Scenario Nurse Chris is teaching Derek and Deborah about exercise. Question Nurse Chris is teaching Derek and Deborah about exercise and diabetes management. Which of the following statements by Derek indicates an understanding of the teaching? Selected Option "I should eat a complex carbohydrate snack before I exercise." Rationale Nurse Chris should confirm that Derek should consume a carbohydrate snack before exercise to decrease the risk of hypoglycemia. Derek should have an additional snack during prolonged episodes of exercise. Optimal Decision Scenario Nurse Tammy uses therapeutic communication with Derek. Question Nurse Tammy is addressing Derek’s concern about his peers making fun of him because he has to check his blood glucose level. Which of the following responses should Nurse Tammy make? Selected Option "Sometimes a person who has diabetes feels embarrassed when they have to check their blood sugar in front of others. Have you ever felt that way?" Rationale Nurse Tammy should use therapeutic communication techniques to encourage Derek to explore and share his feelings about diabetes management. Using a third-person technique is often less threatening to children, which encourages further communication. Optimal Decision Scenario Nurse Tammy is teaching Derek about atraumatic finger sticks. Question Nurse Tammy is addressing Derek’s concerns about fingersticks. Which of the following information should Nurse Tammy include in the teaching? Selected Option Use a cotton ball to wipe away the first drop of blood from the puncture site. Rationale Nurse Tammy should instruct Derek to wipe away the first drop of blood following the puncture. Derek should use the next drop of blood to test his blood glucose level. While this information is correct to include in the teaching, it would be better for Nurse Tammy to address Derek’s concern about pain from finger sticks. Page 6 of 6 Report Created on: 10/24/2019 06:09 PM EDT REP_RSIndv_ModuleReport_1_0 Individual Report – Score Explanation and Interpretation Reasoning Scenario Information: Reasoning Scenario Information provides the date, time and duration of use, along with the score earned for each attempt. A Reasoning Scenario Performance score of Strong, Satisfactory, or Needs Improvement is provided for each attempt. This information is also provided for the Optimal Decision Mode if it has been enabled. Reasoning Scenario Performance Scores: Strong Exhibits optimal reasoning that results in positive outcomes in the care of clients and resolution of problems. Satisfactory Exhibits reasoning that results in mildly helpful or neutral outcomes in the care of clients and resolution of problems. Needs Improvement Exhibits reasoning that results in harmful or detrimental outcomes in the care of clients and resolution of problems. Reasoning Scenario Performance Related to Outcomes: A clinical reasoning performance score related to each outcome is provided. Outcomes associated with student responses are listed in the report. The number across from each outcome indicates the percentage of responses associated with the level of performance of that outcome. NCLEX® Client Need Categories: Management of Care Providing integrated, cost‐effective care to clients by coordinating, supervising, and/or collaborating with members of the multi‐disciplinary health care team. Safety and Infection Control Incorporating preventative safety measures in the provision of client care that provides for the health and well‐being of clients, significant others, and members of the health care team. Health Promotion and Maintenance Providing and directing nursing care that encourages prevention and early detection of illness, as well as the promotion of health. Psychosocial Integrity Promoting mental, emotional, and social well‐being of clients and significant others through the provision of nursing care. Basic Care and Comfort Promoting comfort while helping clients perform activities of daily living. Pharmacological and Parenteral Therapies Providing and directing administration of medication, including parenteral therapy. Reduction of Risk Potential Providing nursing care that decreases the risk of clients developing health‐ related complications. Physiological Adaptation Providing and directing nursing care for clients experiencing physical illness. Quality and Safety Education for Nurses (QSEN) Safety The minimization of risk factors that could cause injury or harm while promoting quality care and maintaining a secure environment for clients, self, and others. Patient‐Centered Care The provision of caring and compassionate, culturally sensitive care that is based on a client’s physiological, psychological, sociological, spiritual, and cultural needs, preferences, and values Evidence Based Practice The use of current knowledge from research and other credible sources, upon which clinical judgment and client care are based. Informatics The use of information technology as a communication and information gathering tool that supports clinical decision making and scientifically based nursing practice. Quality Improvement Care related and organizational processes that involve the development and implementation of a plan to improve health care services and better meet the needs of clients. Teamwork and Collaboration The delivery of client care in partnership with multidisciplinary members of the health care team, to achieve continuity of care and positive client outcomes. Body Function Cardiac Output and Tissue Perfusion Cognition and Sensation The anatomical structures (heart, blood vessels, and blood) and body functions that support adequate cardiac output and perfusion of body tissues. The anatomical structures (brain, central and peripheral nervous systems, eyes and ears) and body functions that support perception, interpretation, and response to internal and external stimuli. Excretion The anatomical structures (kidney, ureters, and bladder) and body functions that support filtration and excretion of liquid wastes, regulate fluid and electrolyte and acid‐base balance. Immunity The anatomic structures (spleen, thymus, bone marrow, and lymphatic system) and body functions related to inflammation, immunity, and cell growth. Ingestion, Digestion, Absorption and Elimination The anatomical structures (mouth, esophagus, stomach, gall bladder, liver, small and large bowel, and rectum) and body functions that support ingestion, digestion, and absorption of food and elimination of solid wastes from the body. Integument The anatomical structures (skin, hair, and nails) and body functions related to protecting the inner organs from the external environment and injury. Mobility The anatomical structures (bones, joints, and muscles) and body functions that support the body and provide its movement. Oxygenation The anatomical structures (nose, pharynx, larynx, trachea, and lungs) and body functions that support adequate oxygenation of tissues and removal of carbon dioxide. Regulation and Metabolism The anatomical structures (pituitary, thyroid, parathyroid, pancreas, and adrenal glands) and body functions that regulate the body’s internal environment. Reproduction The anatomical structures (breasts, ovaries, fallopian tubes, uterus, vagina, vulva, testicles, prostate, scrotum, and penis) and body functions that support reproductive functions. Decision Log Information related to each question answered in a scenario attempt is listed in the report. A brief description of the scenario, question, selected option and rationale for that option are provided for each question answered. The words “Optimal Decision” appear next to the question when the most optimal option was selected. The rationale for each selected option may be used to guide remediation. A variety of learning resources may be used in the review process, including related ATI Review Modules.