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Zorluk: OrtaPharmacological and Parenteral Therapies

A nurse is preparing to administer a mixed dose of 5 units of regular insulin and 15 units of NPH insulin to a client with type 2 diabetes mellitus before breakfast. Place the following steps for preparing this medication in a single syringe in the correct chronological order.

  1. 1Roll the NPH insulin vial gently between the palms.
  2. 2Cleanse the rubber stoppers of both insulin vials with an alcohol swab.
  3. 3Inject 15 units of air into the NPH insulin vial without allowing the needle to touch the solution.
  4. 4Inject 5 units of air into the regular insulin vial, invert the vial, and withdraw 5 units of regular insulin.
  5. 5Insert the needle into the NPH insulin vial, invert the vial, and withdraw 15 units of NPH insulin.

Cevap

The correct chronological sequence is: roll the NPH vial, cleanse both stoppers, inject air into the NPH vial, inject air into and withdraw the regular insulin, and finally withdraw the NPH insulin.
The standard sequence for mixing insulins ensures both accurate dosing and prevention of cross-contamination. NPH must be rolled to suspend the particles safely. Stopper cleansing ensures sterility. Air must be injected into both vials to prevent a vacuum. Injecting air into the NPH vial first, followed by the regular insulin, allows the nurse to draw up the regular (clear) insulin first. This 'clear before cloudy' rule is critical to prevent the intermediate-acting NPH from contaminating the rapid-acting regular insulin vial.

Adım Adım Çözüm

1
Roll the NPH insulin vial.
The suspension is mixed evenly.
Ensures accurate dosing without creating air bubbles that form if the vial is shaken.
2
Cleanse the rubber stoppers of both vials.
The tops of the vials are sanitized.
Prevents introduction of pathogens into the sterile medication.
3
Inject air into the NPH vial first.
Pressure is equalized in the NPH vial.
Prevents vacuum formation; doing this first avoids contaminating the clear insulin with cloudy insulin.
4
Inject air into the regular insulin vial and withdraw the medication.
The regular insulin is drawn into the syringe.
Drawing clear insulin first prevents accidental contamination of the rapid-acting regular insulin vial with the longer-acting NPH insulin.
5
Withdraw the NPH insulin.
The total mixed dose is prepared in the syringe.
Completes the medication preparation while maintaining the purity of both insulin vials.

Anahtar Kavram

Safe medication preparation and mixing of insulin (Clear before Cloudy)
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Konular

Pharmacological and Parenteral Therapies

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