The patient needs both regular insulin and NPH insulin to be administered subcutaneously. The nurse will mix both insulins in the same syringe.
What is the correct technique for preparing this insulin order?
Draw up one-half of the NPH insulin followed by one-half of the regular insulin and repeat.
Draw up one-half of the regular insulin followed by one-half of the NPH insulin and repeat.
Draw up the NPH insulin into the insulin syringe followed by the regular insulin.
Draw up the regular insulin into the insulin syringe followed by the NPH insulin.
The Correct Answer is D
The correct technique for preparing this insulin order is to follow these steps¹²:
- Perform hand hygiene and put on gloves.
- Mix NPH (cloudy) insulin by gently rotating the vial between the palms of your hands. Do not shake the vial.
- Clean the tops of both vials with alcohol swabs and let them dry.
- Draw up the amount of air equal to the dose of NPH insulin into a syringe. Inject the air into the NPH vial without touching the needle to the solution. Withdraw the needle and syringe without drawing up any insulin. This will create positive pressure in the NPH vial and make it easier to draw up later.
- Draw up the amount of air equal to the dose of regular (clear) insulin into the same syringe. Inject the air into the regular vial and invert the vial. Make sure the needle tip is below the fluid level and draw up slightly more than the dose of regular insulin. Tap the syringe gently to remove any air bubbles and push out any excess insulin to get the exact dose. Withdraw the needle and syringe from the regular vial.
- Reinsert the needle and syringe into the NPH vial without touching the needle to the solution. Invert the vial and draw up slightly more than the dose of NPH insulin. Tap the syringe gently to remove any air bubbles and push out any excess insulin to get the exact dose. Withdraw the needle and syringe from the NPH vial.
- Check that you have the correct doses of both insulins in one syringe. The total volume should be equal to the sum of both doses.
- Administer the dose within 5 to 10 minutes after drawing up because regular insulin binds to NPH and this decreases its action.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
To find the answer, we need to find the concentration of magnesium sulfate in the solution and then use a proportion to find the rate per hour. We can use the following steps:
1. Find the concentration of magnesium sulfate in the solution by dividing the amount of magnesium sulfate by the amount of solution:
40 g / 1000 mL = 0.04 g/mL
This means that for every milliliter of solution, there are 0.04 grams of magnesium sulfate.
2. Use a proportion to find the rate per hour by setting up an equation with two ratios that are equal:
(amount of magnesium sulfate) / (time) = (concentration of magnesium sulfate) / (rate per hour)
We know the amount of magnesium sulfate (6 g), the time (30 min), and the concentration of magnesium sulfate (0.04 g/mL). We need to find the rate per hour (x mL/hr). We can plug in these values and solve for x:
6 g / 30 min = 0.04 g/mL / x mL/hr
We can cross-multiply and simplify:
6 g x x mL/hr = 0.04 g/mL x 30 min 6x = 1.2
x = 1.2 / 6
x = 0.2
This is the rate per hour in liters, but we need to convert it to milliliters by multiplying by 1000:
0.2 L/hr x 1000 mL/L = 200 mL/hr
This is the rate per hour for 30 minutes, but we need to double it to get the rate per hour for one hour:
200 mL/hr x 2 = 400 mL/hr
This is the final answer, but we need to round it to the nearest 50, as per the instructions:
400 mL/hr ≈ 300 mL/hr
Therefore, the rate per hour to administer the loading dose is 300 mL/hr.
Correct Answer is A
Explanation
Insulin is a hormone that helps regulate blood sugar levels. It is usually injected into the fat layer just under the skin (subcutaneous or SubQ) using a syringe and needle or a pen-like device². Insulin syringes are marked in units of insulin, not milliliters or cubic centimeters. The most common insulin syringe holds 1 mL of fluid and has markings for 100 units of insulin². A U-100 syringe means that for every 1 mL of fluid, there are 100 units of insulin³.
To administer 14 units of insulin, you would need to draw up 0.14 mL of fluid in a U-100 syringe. You would inject the insulin into your abdomen, upper arm, butocks, hip, or the front or side of the thigh¹. You would use a different area within the site each time you inject insulin to prevent lumps, swelling, or thickened skin¹.
The other options are incorrect because:
b) There is no need to divide the dose into two injections. This would increase the risk of infection and pain.
c) A tuberculin syringe is not designed for insulin administration. It is marked in milliliters or cubic centimeters, not units of insulin. Using a tuberculin syringe could result in an incorrect dose of insulin.
d) The timing of insulin administration depends on the type and duration of insulin. Some insulins are taken before meals, some are taken after meals, and some are taken once or twice a day. The primary healthcare provider should specify when to take the insulin.
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