A nurse is preparing to administer a mixed dose of NPH insulin and regular insulin to a client with diabetes mellitus. Arrange the steps of the medication preparation procedure in the correct chronological order.
- 1Roll the NPH insulin vial gently between the palms of the hands.
- 2Inject a volume of air equal to the prescribed dose into the NPH insulin vial.
- 3Inject a volume of air equal to the prescribed dose into the regular insulin vial.
- 4Invert the regular insulin vial and withdraw the prescribed dose into the syringe.
- 5Invert the NPH insulin vial and withdraw the prescribed dose into the syringe.
Cevap
The correct sequence is to first roll the NPH vial, then inject air into the NPH vial, inject air into the regular insulin vial, withdraw the regular insulin, and finally withdraw the NPH insulin.
When mixing NPH (intermediate-acting) and regular (short-acting) insulin, the standard safety protocol is 'clear before cloudy' for drawing up the medication, while injecting air follows the 'cloudy before clear' sequence. Rolling the NPH vial first safely suspends the particles. Injecting air into the NPH vial first, followed by the regular vial, ensures pressure is equalized without transferring medication. Withdrawing the regular insulin first ensures that if any accidental transfer occurs, the short-acting regular insulin remains uncontaminated, preventing dangerous alterations to its rapid onset and peak times.
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Anahtar Kavram
Insulin Mixing Sequence (Clear before Cloudy)