A client is to receive glargine (Lantus) insulin in addition to a dose of aspart (NovoLog). When the nurse checks the blood glucose level at the bedside, it is greater than 200 mg/dL. How should the nurse administer the insulins?
- Put air into the glargine insulin vial, and then air into the aspart insulin vial, and draw up the correct dose of aspart insulin first.
- Roll the glargine insulin vial, then roll the aspart insulin vial. Draw up the longer-acting glargine insulin first.
- Shake both vials of insulin before drawing up each dose in separate insulin syringes.
- Put air into the glargine insulin vial, and draw up the correct dose in an insulin syringe; then, with a different insulin syringe, put air into the aspart vial and draw up the correct dose.
The Correct Answer and Explanation is :
The correct answer is:
4. Put air into the glargine insulin vial, and draw up the correct dose in an insulin syringe; then, with a different insulin syringe, put air into the aspart vial and draw up the correct dose.
Explanation:
When administering both glargine (Lantus) and aspart (NovoLog) insulin, the following steps ensure proper technique and avoid mixing insulins that could affect their efficacy:
- Glargine (Lantus) is a long-acting insulin, designed to provide a steady release of insulin over 24 hours. It is typically injected once daily and should not be mixed with other insulins due to the risk of altering its prolonged action.
- Aspart (NovoLog) is a rapid-acting insulin used to manage blood glucose spikes, especially with meals. It is injected to address the immediate rise in blood glucose levels, often used in combination with a long-acting insulin like glargine.
To administer these insulins together, the correct technique involves:
- Using two separate syringes: one for each type of insulin.
- Air injection into each vial: Injecting air into the glargine vial before drawing it up prevents contamination, and doing the same with the aspart vial ensures it doesn’t create a vacuum, making the drawing process smoother.
- Glargine insulin should be drawn up first in its separate syringe because it cannot be mixed with aspart insulin, which could alter its properties and effectiveness.
Why not the other options?
- Option 1: Drawing up aspart insulin first is incorrect because glargine should always be drawn up first in a separate syringe to avoid contamination.
- Option 2: Rolling the insulin vials is not the recommended method, as shaking or rolling insulin vials (especially for glargine) can alter its structure and effectiveness. It should only be gently rolled, and it’s not appropriate to mix the insulins.
- Option 3: Shaking the vials is discouraged because it can cause the insulin to lose its potency, particularly in long-acting insulins like glargine.
By following the steps outlined in Option 4, the nurse ensures that the insulins are administered safely and effectively, maintaining their therapeutic action.