Drawing up More than One Type of Insulin

When preparing an injection of mixed insulin that includes 12 units of NPH and 5 units of regular insulin, how does the nurse initially confirm the proper dosage in the syringe? A. By noting when 5 units of clear insulin is visible in the syringe B. By noting when 12 units of cloudy insulin is visible in the syringe C. By having another registered nurse verify the presence of 17 units of insulin D. By verifying that the prescription confirms the medication administration record (MAR)

By noting when 5 units of clear insulin is visible in the syringe Rationale: Because it is clear, regular insulin will be drawn into the syringe first, so it is the first thing the nurse will verify as she draws the proper dosage. NPH or cloudy insulin is not drawn into the syringe first. While this confirms the correct total insulin volume, it fails to confirm the first step of drawing the clear, regular insulin. Although this confirms the amount of insulin prescribed, which is important, it does not address the amount of insulin in the syringe.

When preparing an injection that contains both short- and intermediate-acting insulins, what is the first step the nurse would take to ensure the effectiveness of the injection? A. Insert air into the intermediate-acting insulin. B. Warm the vials to room temperature. C. Shake the vials to disperse the medication within the suspension. D. Withdraw the prescribed amount of short-acting insulin after the intermediate-acting insulin.

Insert air into the intermediate-acting insulin. Rationale: Air is injected into the intermediate-acting insulin before it is injected into the short-acting insulin. Warming the vials to room temperature will enhance patient comfort but will not ensure the effectiveness of the insulin injection. Shaking insulin is not recommended, as it may damage the protein molecules. Short-acting insulin must be drawn up before intermediate-acting insulin.

The patient is to receive both Lantus® (insulin glargine) and regular insulin. To ensure the proper action of the insulins, what would the nurse do when preparing these two types of insulin for administration? A. Mix the insulins in one syringe for a single injection. B. Prepare the insulins in two syringes for separate injections. C. Roll each vial between the palms to disperse the medication within the suspension. D. Have another registered nurse verify the dose of the insulins.

Prepare the insulins in two syringes for separate injections. Rationale: Lantus is not to be mixed with other insulins. Separate injections are required. Lantus and regular insulins are solutions and do not settle out. Verifying the dose is important but will not affect the proper action of the insulins.

Which action would the nurse take when mixing intermediate- and long-acting insulins together in one syringe? A. Draw the intermediate-acting insulin into the syringe first. B. Draw the long-acting insulin into the syringe first. C. Prepare two injections. D. Draw either the intermediate- or the long-acting insulin into the syringe first.

Prepare two injections. Rationale: You never mix long-acting insulin with any other insulins. You would need to prepare two injections because you never mix long-acting insulin with any other insulins.

The nurse is preparing to mix short- and intermediate-acting insulins to administer to a patient. Which action best preserves the insulin's effectiveness? A. Determining the patient's blood glucose level B. Refraining from injecting the intermediate-acting insulin into the short-acting vial C. Applying clean gloves when administering the medication D. Having another registered nurse verify the dose of both types of insulins

Refraining from injecting the intermediate-acting insulin into the short-acting vial Rationale: Refraining from injecting the intermediate-acting insulin into the short-acting vial will prevent the short-acting insulin vial from being contaminated with intermediate-acting insulin. Determining the patient's blood glucose level will not ensure the effectiveness of the insulin. Wearing clean gloves will not ensure the effectiveness of the insulin. Having another nurse verify the dose will not ensure the effectiveness of the insulin.