Question

A client, age 23, is diagnosed with type 1 diabetes. The physician prescribes 15 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. The nurse checks the medication order, assembles the appropriate equipment, washes her hands, rotates the NPH insulin vial, puts on disposable gloves, and cleans the stoppers. To draw the two insulin doses into the single U-100 insulin syringe, which sequence should the nurse use?

Answer 1

When mixing insulin, first inject air into the NPH vial, then into the regular insulin vial without withdrawing any insulin. Afterwards, withdraw the regular insulin, then the NPH insulin. This sequence helps prevent contamination and ensures the correct action of the different types of insulin.

Step-by-step explanation:

To draw two types of insulin into a single U-100 insulin syringe, the correct sequence is to first inject air into the NPH insulin vial equivalent to the dose you plan to withdraw, then do the same for the regular insulin vial. After injecting air into both vials, you withdraw the regular insulin first, followed by the NPH insulin. This sequence is important because it prevents the NPH insulin, which is cloudy and has a longer action, from contaminating the regular insulin, which is clear and has a shorter action. Additionally, drawing up the regular insulin first minimizes the risk of hypoglycemia by ensuring that the short-acting insulin is not delayed in its action by the longer-acting NPH if it were to be administered later.

Insulin injections are a critical part of managing type 1 diabetes. They help to decrease blood glucose levels after consuming a meal, facilitating the transport and storage of glucose into the body's cells. For someone with diabetes, particularly insulin-dependent diabetes mellitus (IDDM), also known as type 1 diabetes, insulin shots are necessary to maintain normal blood glucose levels and must be taken for life. These injections are lifesaving, particularly after consuming a large or high-glucose meal, as they assist the body in utilizing glucose more effectively. Without proper management of blood glucose levels through insulin injections, individuals with type 1 diabetes are at risk of serious health complications.