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Zorluk: OrtaPharmacological and Parenteral Therapies

A nurse is preparing to administer a mixed dose of regular insulin and NPH insulin in a single syringe for a client with diabetes mellitus. In what order should the nurse perform the following actions? Arrange the steps in the correct chronological order from first to last.

  1. 1Roll the vial of NPH insulin between the palms of the hands.
  2. 2Inject a volume of air equal to the prescribed dose into the NPH insulin vial.
  3. 3Inject a volume of air equal to the prescribed dose into the regular insulin vial.
  4. 4Withdraw the prescribed dose of regular insulin from the vial.
  5. 5Withdraw the prescribed dose of NPH insulin from the vial.

Cevap

The correct sequence for mixing insulins 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.
When mixing regular and NPH insulin, the sequence is specifically designed to prevent contaminating the regular (clear) insulin with the NPH (cloudy) insulin. The correct, safe process is to first gently roll the NPH vial to resuspend the particles, inject air into the NPH vial, inject air into the regular vial, draw up the regular insulin, and finally draw up the NPH insulin.

Adım Adım Çözüm

1
Roll the vial of NPH insulin between the palms of the hands.
The insulin suspension is mixed without creating air bubbles.
NPH insulin is a suspension that separates upon standing. Rolling mixes it evenly, whereas shaking creates bubbles that can lead to an inaccurate dose.
2
Inject a volume of air equal to the prescribed dose into the NPH insulin vial.
Air pressure in the NPH vial is equalized.
Injecting air prevents negative pressure within the vial, facilitating easier medication withdrawal later. This is done first for the NPH vial, being careful not to let the needle touch the liquid to avoid contaminating the needle before it enters the regular insulin vial.
3
Inject a volume of air equal to the prescribed dose into the regular insulin vial.
Air pressure in the regular insulin vial is equalized.
Air is injected into the regular insulin vial next. The needle is left in the vial, and the vial is inverted to prepare for immediate withdrawal of the medication.
4
Withdraw the prescribed dose of regular insulin from the vial.
The exact dose of regular insulin is drawn into the syringe.
Regular insulin (which is clear) must always be drawn up before NPH insulin (which is cloudy). This prevents accidental contamination of the rapid-acting regular insulin vial with the longer-acting NPH insulin.
5
Withdraw the prescribed dose of NPH insulin from the vial.
The exact dose of NPH insulin is added to the syringe, completing the mixed dose.
NPH insulin is drawn last. The nurse must carefully withdraw only the exact amount needed, as the syringe already contains the regular insulin and cannot be pushed back into the vial.

Anahtar Kavram

The principle of 'Clear before Cloudy' when mixing insulins to prevent cross-contamination of vials.
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Konular

Pharmacological and Parenteral Therapies

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