A client with diabetes mellitus is prescribed a morning dose of 10 units of regular insulin and 20 units of NPH insulin. The nurse will mix both insulins in a single syringe. In what order should the nurse perform the following actions? Arrange the steps in the correct chronological sequence from first to last.
- 1Roll the vial of NPH insulin gently between the palms of the hands.
- 2Inject 20 units of air into the NPH insulin vial without touching the fluid.
- 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 20 units of NPH insulin.
Answer
The correct sequence is: 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 correct sequence for mixing insulins is designed to prevent the contamination of the short-acting (clear) insulin with the intermediate-acting (cloudy) insulin. The correct sequence for injecting air is the reverse of drawing up: air into NPH (cloudy), air into Regular (clear). Then, draw up Regular (clear), followed by drawing up NPH (cloudy).
Step-by-Step Solution
Key Concept
When mixing insulins in a single syringe, always draw up the clear (short-acting or rapid-acting) insulin before the cloudy (intermediate-acting) insulin to prevent cross-contamination.