A practical nurse is preparing to administer a morning dose consisting of of regular insulin and of NPH insulin to a client with type 2 diabetes mellitus. After performing hand hygiene, in what order should the nurse perform the following actions to safely prepare the mixed injection? Arrange the steps in the correct chronological sequence.
- 1Roll the NPH insulin vial gently between the palms of the hands.
- 2Cleanse the rubber stoppers of both the regular and NPH insulin vials with alcohol swabs.
- 3Inject of air into the NPH insulin vial without allowing the needle to touch the insulin.
- 4Inject of air into the regular insulin vial and leave the needle in the vial.
- 5Invert the regular insulin vial and withdraw of regular insulin.
- 6Insert the needle into the NPH insulin vial, invert it, and withdraw of NPH insulin.
Cevap
The correct sequence is to first roll the NPH vial, then cleanse both vials, 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 follows the 'Clear before Cloudy' principle. The nurse must first prepare the medication by rolling the NPH suspension and disinfecting the vials. Air must be injected into the cloudy vial first, followed by the clear vial, to pressurize them. The clear (regular) insulin is then withdrawn first to ensure no cloudy (NPH) insulin accidentally enters and contaminates the clear insulin vial.
Adım Adım Çözüm
Anahtar Kavram
When mixing insulins, the regular (clear, short-acting) insulin must be drawn up before the NPH (cloudy, intermediate-acting) insulin to prevent contamination of the rapid-acting insulin.