A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to a client who has diabetes mellitus.
Which of the following actions should the nurse take first?
A.
Inject air into the NPH vial.
B.
Withdraw the NPH insulin from the vial.
C.
Withdraw the regular insulin from the vial.
D.
Inject air into the regular insulin vial.
The Correct Answer and Explanation is:
The correct answer is A. Inject air into the NPH vial.
Explanation:
When mixing insulins, particularly regular (short-acting) insulin and NPH (intermediate-acting) insulin, it’s crucial to follow the proper technique to ensure the correct dosage and effectiveness of the medication. The process involves several important steps:
- Inject Air into the Vials: Before drawing insulin from a vial, you must first inject air into each vial to create a pressure balance. This step helps to avoid creating a vacuum inside the vial, which could make it difficult to withdraw the insulin. For mixed insulin, you start with the NPH vial. By injecting air into the NPH vial first, you prevent contamination of the regular insulin vial with the NPH insulin. This technique ensures that the insulin drawn from each vial is the correct type and dose. The key here is that you need to inject air into the vial you are not currently drawing from. In this case, injecting air into the NPH vial first is the correct procedure.
- Withdraw the Regular Insulin: After injecting air into the NPH vial, you then withdraw the required amount of regular insulin. Regular insulin should be drawn first because it is clear and short-acting. This prevents any potential contamination of the clear insulin with the cloudy NPH insulin.
- Inject Air into the NPH Vial: Following the withdrawal of the regular insulin, you then inject air into the NPH vial. This step is necessary to facilitate the withdrawal of NPH insulin, as it maintains proper pressure inside the vial.
- Withdraw the NPH Insulin: Finally, you withdraw the NPH insulin, making sure to use the same syringe that contains the regular insulin. This ensures that the mixture is accurate and ready for administration.
The correct order of operations is crucial for preventing contamination and ensuring the correct dosage of each type of insulin. Injecting air into the NPH vial first helps to avoid mixing the two types of insulin inappropriately, maintaining the integrity of both insulins and ensuring effective treatment for the client with diabetes mellitus.