A nurse is teaching a client how to draw up regular insulin and NPH insulin in the same syringe. Which of the following instructions should the nurse include?
A.
Inject air into the regular insulin first.
B.
Shake the NPH insulin until it is well mixed.
C.
Draw up the NPH insulin into the syringe first.
D.
Discard regular insulin that appears cloudy.
The correct answer and Explanation is :
The correct instruction for the nurse to include is:
B. Shake the NPH insulin until it is well mixed.
Explanation:
When administering a combination of regular insulin (a short-acting insulin) and NPH insulin (an intermediate-acting insulin), it’s important to follow the correct procedure to ensure accurate dosing and effectiveness of the medication.
1. Shaking the NPH Insulin:
NPH insulin is cloudy because it contains a suspension of insulin crystals. Before drawing it up, it must be mixed thoroughly. This is done by gently rolling the vial between the palms of your hands rather than shaking it vigorously. Shaking too hard can cause bubbles, which may lead to inaccurate dosing. The goal is to ensure that the insulin is evenly distributed throughout the solution.
2. Injecting Air into the Vials:
Before drawing up insulin, you should inject air into both the NPH and regular insulin vials. This step prevents creating a vacuum that can make it difficult to withdraw insulin. However, this is not the specific instruction here.
3. Drawing Up Insulin:
The correct order to draw up insulin is crucial. First, you draw up the regular insulin, then the NPH insulin. This prevents contamination of the short-acting insulin with the intermediate-acting insulin. If you draw the NPH insulin first, it can introduce particles into the regular insulin, affecting its effectiveness.
4. Appearance of Insulin:
Regular insulin should always be clear. If it appears cloudy, it should not be used. Cloudiness in regular insulin indicates that it might be spoiled or improperly stored, which could impact its efficacy and safety.
To summarize, when preparing to administer a mixture of regular and NPH insulin, the nurse should ensure the NPH insulin is well mixed, draw up the clear regular insulin first, then the NPH insulin, and always check for proper appearance before administration.