A practical nurse is preparing to administer 10 units of regular insulin and 15 units of NPH insulin subcutaneously to a client with type 2 diabetes mellitus. Arrange the steps for preparing this medication in the correct chronological sequence.
- 1Roll the NPH insulin vial gently between the palms of the hands.
- 2Inject 15 units of air into the NPH insulin vial without letting the needle touch the liquid.
- 3Inject 10 units of air into the regular insulin vial and leave the needle in the vial.
- 4Invert the regular insulin vial and withdraw 10 units of regular insulin.
- 5Insert the needle into the NPH insulin vial and withdraw 15 units of NPH insulin.
Answer
The correct sequence for mixing insulins is: 1) Roll the NPH vial, 2) Inject air into NPH, 3) Inject air into regular, 4) Withdraw regular insulin, 5) Withdraw NPH insulin.
When mixing intermediate-acting (NPH, cloudy) and short-acting (regular, clear) insulins, the standard sequence 'clear before cloudy' prevents the contamination of the short-acting insulin with the longer-acting insulin. The nurse must first gently roll the NPH vial to resuspend the particles. Next, air must be injected into both vials to equalize pressure, starting with the NPH vial to ensure the needle does not inadvertently carry NPH insulin into the regular insulin vial. Finally, the regular insulin is drawn up, followed by the NPH insulin.
Step-by-Step Solution
Key Concept
Safe Medication Administration: Mixing Insulins
Estimated Time:1m 30s