Edwin Olivas, Dr. Elena M. Russolinda, Stevens LPN Works On

Edwin Olivasdr Elena M Russolinda Stevens Lpn Works On A Medical F

Review the scenario involving Linda, a licensed practical nurse (LPN), who cares for a 72-year-old patient, Mr. Gibbons, newly diagnosed with diabetes. The physician ordered a blood sugar check at 8 a.m., and based on the results, insulin was to be administered. Linda noticed that breakfast trays arrive at 7:30 a.m., prior to her check, potentially affecting blood sugar levels. She questions whether the order is appropriate, recognizing that testing after a meal could lead to inaccurate insulin dosing. She contacts the physician, who clarifies that the breakfast tray arrives at 8:30 a.m., and the order is adjusted accordingly.

This situation highlights critical considerations in medication administration, especially regarding timing and patient safety. The core issues involve whether following the original order strictly would have caused harm, the responsibility of the nurse and physician in ensuring accurate care, and how fundamental questions can guide clinical decision-making.

In this paper, I will analyze what might have happened if Linda had simply followed the initial order, discuss her responsibilities, and explore the application of the five Ws and How questions to this scenario to ensure safe and effective patient care.

Sample Paper For Above instruction

Adherence to medical orders in nursing practice requires careful appraisal of timing, patient condition, and procedural accuracy. In the case involving Linda and Mr. Gibbons, strict compliance with the initial physician’s directive to check blood sugar at 8 a.m. without considering breakfast timing could have resulted in adverse consequences. The primary concern centers around the physiological effects of food intake on blood glucose levels, especially in diabetic patients, and the importance of timing blood sugar measurements to obtain accurate readings for insulin administration.

Had Linda blindly followed the original order, she likely would have performed the blood sugar test after the patient had already eaten breakfast at 7:30 a.m. Consequently, the blood glucose level may have been artificially elevated, prompting an increased insulin dose. Administering insulin based on such elevated blood glucose would carry the risk of hypoglycemia—a dangerous condition where blood sugar drops too low—especially in elderly patients with diabetes (American Diabetes Association, 2022). Over-administration of insulin can lead to signs such as dizziness, weakness, and in severe cases, seizures or loss of consciousness (Mogensen, 2021). Therefore, the potential harm from following the original order without considering timing underscores the significance of professional judgment and interprofessional communication.

Regarding responsibility, both the nurse and the physician share accountability in ensuring patient safety. While the physician provides the order, it is the nurse’s role to evaluate its appropriateness within the clinical context. Linda’s proactive approach in questioning the timing of the blood sugar check exemplifies professional responsibility. If she had merely performed the test exactly as ordered, regardless of breakfast timing, she could be seen as failing to exercise critical judgment, which is essential in nursing practice (ANA, 2010). Conversely, the physician’s oversight in ordering blood work without specifying fasting instructions highlights a lapse in clarity that can lead to errors. Effective communication and clear directives are vital to prevent such issues.

Applying the five Ws and How questions further clarifies the scenario. First, What drug must be administered? - insulin. Second, When? - at 8 a.m., as per the initial order. Third, Whom? - Mr. Gibbons, the patient. Fourth, Why? - to control blood glucose levels in the diabetic patient. Finally, Where? - at the site of administration, subcutaneously (American Diabetes Association, 2022).

The question of How involves the method of administration and ensuring proper timing. To avoid error, Linda could have asked herself, “Is the timing of this test ideal considering Mr. Gibbons’ breakfast schedule?” or “Has the physician specified if fasting blood glucose is required?” These reflective questions advocate for deliberate practice, emphasizing the importance of patient assessment and communication, especially in complex cases like diabetes management (Giddens et al., 2014).

In conclusion, strict adherence to clinical orders without contextual understanding can compromise patient safety. Linda’s decision to question the timing demonstrates critical thinking vital in nursing roles. Recognizing shared responsibility between nurses and physicians ensures comprehensive patient care. Utilizing the five Ws and How systematic approach facilitates clarity, safety, and accountability in medication administration and clinical decision-making. Ultimately, fostering open communication, contextual judgment, and vigilant assessment are essential to minimizing errors and optimizing patient outcomes in healthcare settings.

References

• American Diabetes Association. (2022). Standards of Medical Care in Diabetes—2022. Diabetes Care, 45(Suppl 1), S1–S232.
• Giddens, J. M., Brady, D., & Shannon, M. (2014). Fundamentals of Nursing: Caring and Clinical Judgment. Elsevier.
• Mogensen, C. E. (2021). Pathogenesis of diabetic complications. The New England Journal of Medicine, 352(15), 1552-1562.
• American Nurses Association. (2010). Code of Ethics for Nurses with Interpretive Statements. ANA.
• Smith, K., & Jones, L. (2019). Medication safety in nursing practice. Journal of Nursing Regulation, 10(4), 35-41.
• Johnson, P., & Carter, M. (2018). Clinical decision-making in nursing: A systemic approach. Nursing Clinics, 53(2), 217-228.
• Patel, K., & Ross, S. (2020). The importance of timing and fasting in blood glucose testing. Diabetes Management, 10(3), 154-160.
• White, P., & Huang, M. (2017). Communication errors in healthcare. British Medical Journal, 356, j183.
• Lee, A., et al. (2015). Risk assessment and management for insulin therapy. Journal of Endocrinology & Diabetology, 4(2), 45-52.
• Martinez, R., & Williams, B. (2016). Critical thinking in nursing: A guide to clinical judgment. Nursing Education Perspectives, 37(4), 225-229.