A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if their blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?
A.
Discard the NPH solution if it appears cloudy.
B.
NPH is an intermediate-acting insulin.
C.
Freeze unopened insulin vials.
D.
Shake the insulin vigorously before loading the syringe.
The correct answer and Explanation is :
The correct answer is B. NPH is an intermediate-acting insulin.
Explanation:
NPH (Neutral Protamine Hagedorn) insulin is classified as an intermediate-acting insulin. This means it typically starts to lower blood glucose levels within 1 to 2 hours after injection, reaches its peak effect in about 4 to 12 hours, and continues to work for approximately 18 to 24 hours. This characteristic makes NPH insulin suitable for providing basal insulin coverage throughout the day or night.
Here’s why the other options are incorrect:
A. Discard the NPH solution if it appears cloudy.
NPH insulin is inherently cloudy due to the presence of added protamine, which slows the absorption of insulin. Therefore, it is normal for NPH insulin to be cloudy. It should not be discarded unless it has become excessively cloudy or contains particles that do not mix upon gentle agitation. Typically, insulin should be clear if it is a rapid-acting or long-acting type (like regular or glargine).
C. Freeze unopened insulin vials.
Insulin should never be frozen. Freezing can damage the insulin, making it ineffective. Unopened insulin vials should be stored in the refrigerator at temperatures between 36°F to 46°F (2°C to 8°C). After opening, insulin vials can generally be kept at room temperature for up to 28 days, depending on the manufacturer’s guidelines.
D. Shake the insulin vigorously before loading the syringe.
Insulin should not be shaken vigorously as it can cause air bubbles and potentially degrade the insulin. For NPH insulin, the vial should be gently rolled or inverted several times to mix the contents before drawing it into the syringe. This gentle mixing ensures that the insulin is evenly distributed and effective.
In summary, understanding the type and characteristics of insulin used in diabetes management is crucial for effective blood glucose control and preventing complications.