Question

A nurse is preparing to administer 15 units of regular insulin along with 20 units of NPH insulin. Which of the following actions should the nurse plan to take?

A) Inject 20 units of air into the NPH insulin vial.
B) Shake the NPH insulin vial vigorously to mix the insulin.
C) Use a new needle to draw up the insulin from the second vial.
D) Draw the longer-acting insulin into the syringe first.

Answer 1

When administering combined regular and NPH insulin, the nurse should inject air into the NPH vial, gently roll the vial to mix, and draw the regular insulin before the NPH. Changing the needle is not typically required if drawing up insulin sequentially for the same patient.

Step-by-step explanation:

A nurse preparing to administer a combination of regular insulin and NPH insulin should take several steps to ensure correct technique and dosage. Specifically:

• Inject air into the NPH vial equivalent to the dose to equalize the pressure, which would be 20 units in this case.
• Gently roll the NPH insulin vial to mix the insulin rather than shaking it vigorously to avoid creating air bubbles and froth which can result in incorrect dosing.
• Draw up the regular insulin (short-acting insulin) first, then draw the NPH (longer-acting insulin) to prevent contaminating the short-acting insulin with the long-acting type since NPH is cloudy and regular insulin is clear.

Note that option C suggests using a new needle for the second vial. While using a new needle is a standard practice to ensure sterility for repeated injections, in the case of drawing up two types of insulin into one syringe, changing the needle is not typically required as long as the same patient is receiving the medication and the drawing up procedure happens in one sequence.

It is important to remember that insulin injections help manage blood glucose levels by facilitating the transport and storage of glucose to decrease blood glucose levels, especially after meals that are high in glucose content.