The nurse is caring for an adolescent who has just been diagnosed with diabetes. The nurse is teaching them about administering their insulin. Their standard morning dose of insulin includes 8 units of NPH and 8 units of regular insulin. The nurse knows that the adolescent understands the instructions when they say:
The nurse is caring for an adolescent who has just been diagnosed with diabetes. The nurse is teaching them about administering their insulin. Their standard morning dose of insulin includes 8 units of NPH and 8 units of regular insulin. The nurse knows that the adolescent understands the instructions when they say:
A. “It doesn’t make any difference which insulin I draw up first.”
[1%]
B. “I cannot mix these two kinds of insulin, so I will have to give myself two shots.”
[5%]
C. “I should draw up the regular insulin first.”
[82%]
D. “I should draw up the NPH insulin first.”
[11%]
Statistics
Subject/Lesson
Subject
Child Health
Lesson
Endocrine
Client Need
Test Plan
Pharmacological and Parenteral Therapies
Related Topic
Expected Actions/Outcomes
Item Type
Item Type
Application
Explanation
Choice C is correct. Regular insulin should be drawn up first. For a mixed dose of two types of insulin, rapid or short-acting insulin should always be drawn up before the intermediate or long-acting insulin. Regular or Novolin insulin is short-acting insulin with an onset within 30-60 minutes and a duration of 5-8 hours. Short-acting insulin covers the needs for meals the individual eats within 60 minutes. NPH insulin is an intermediate-acting insulin with an onset within 1-2 hours and a duration of 18-24 hours. NPH insulin covers the needs for approximately half the day and is often combined with shorter-acting insulin. The concern when mixing insulin is the contamination of the short-acting insulin with longer-acting insulin if some of the NPH is accidentally introduced into the vial of regular insulin. This could cause severe hypoglycemia with subsequent injections from the vial of regular insulin. These two types of insulin can be safely mixed as long as the correct order of drawing them into the syringe is followed.
Choice A is incorrect. The order of drawing up insulin does matter. Drawing up the regular insulin before the NPH insulin is recommended to prevent contamination and ensure accurate dosing. The "clear to cloudy" rule helps maintain the integrity of each insulin type.
Choice B is incorrect. It is possible and common to mix NPH and regular insulin in the same syringe for a combined injection. This helps reduce the number of injections the individual needs to administer.
Choice D is incorrect. Drawing up the NPH insulin first increases the risk of contaminating the vial of clear insulin with the cloudy insulin. The preferred sequence is to draw up the regular insulin first to avoid this potential issue.
Related Videos
2 Key Topics
Insulin
