A practical nurse (PN) is preparing to mix and administer 5 units of regular insulin and 15 units of NPH insulin in a single syringe for a client with diabetes mellitus. In what order should the PN perform the following steps to prepare the medication? Arrange the actions from first to last.
- 1Roll the NPH insulin vial gently between the palms of the hands.
- 2Inject 15 units of air into the NPH insulin vial.
- 3Inject 5 units of air into the regular insulin vial.
- 4Withdraw 5 units of regular insulin into the syringe.
- 5Withdraw 15 units of NPH insulin into the syringe.
Answer
The correct sequence is to roll the NPH vial, inject air into the NPH vial, inject air into the regular insulin vial, withdraw the regular insulin, and finally withdraw the NPH insulin.
The standard procedure for mixing insulins involves drawing up the clear (regular) insulin before the cloudy (NPH) insulin. This 'clear before cloudy' sequence prevents the intermediate-acting NPH insulin from inadvertently mixing into and modifying the action of the short-acting regular insulin vial. Air is injected into both vials beforehand to equalize pressure and facilitate withdrawal.
Step-by-Step Solution
Key Concept
Mixing Insulins (Clear Before Cloudy)