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Zorluk: KolayPharmacological and Parenteral Therapies

A nurse is preparing to mix and administer regular insulin and NPH insulin in a single syringe for a client with diabetes mellitus. Arrange the following steps in the correct chronological order to ensure safe and effective medication preparation.

  1. 1Inject air equal to the prescribed dose into the NPH insulin vial.
  2. 2Inject air equal to the prescribed dose into the regular insulin vial.
  3. 3Withdraw the prescribed dose of regular insulin.
  4. 4Withdraw the prescribed dose of NPH insulin.

Cevap

The correct sequence is to first inject air into the NPH vial, then inject air into the regular vial, withdraw the regular insulin, and finally withdraw the NPH insulin.
When mixing intermediate-acting (NPH, cloudy) and short-acting (regular, clear) insulin, the standard safety protocol is 'clear before cloudy'. First, air is injected into the NPH vial, then air is injected into the regular vial. The regular insulin is then withdrawn first, followed by the NPH insulin. This precise sequence prevents the longer-acting NPH insulin from accidentally contaminating the vial of short-acting regular insulin, which could affect the onset and peak times of future doses.

Adım Adım Çözüm

1
Determine the order for injecting air into the vials.
Air must be injected into the cloudy (NPH) vial first, followed by the clear (regular) vial.
Injecting air equalizes the pressure inside the vials. Doing the NPH vial first ensures the needle does not carry regular insulin into the NPH vial prematurely.
2
Determine the order for withdrawing the medication.
The clear (regular) insulin is withdrawn first, followed by the cloudy (NPH) insulin.
Drawing up the clear insulin before the cloudy insulin prevents accidental contamination of the rapid/short-acting insulin vial with intermediate-acting insulin.

Anahtar Kavram

Safe Preparation of Mixed Insulin (Clear Before Cloudy)
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