A nurse is preparing to administer insulin to a client with diabetes mellitus. The nurse draws up 10 units of regular insulin and 20 units of NPH insulin in the same syringe. Which of the following actions should the nurse take next?
A.
Inject air into the NPH vial
B.
Inject air into the regular vial
C.
Withdraw NPH insulin from the vial
D.
Withdraw regular insulin from the vial
The Correct answer and Explanation is:
The correct answer is B. Inject air into the regular vial.
When preparing to mix insulin, the nurse should follow the “air first” method, particularly when mixing a short-acting insulin (like regular insulin) with an intermediate-acting insulin (like NPH). Here’s a detailed explanation of the steps involved:
- Preparation of Vials: The nurse should begin by ensuring that both insulin vials (regular and NPH) are at room temperature, as this can help with easier mixing and administration.
- Injecting Air into Vials: The first step in the mixing process is to inject air into the regular insulin vial. This step is critical for creating a vacuum that allows for easy withdrawal of the insulin. By injecting air into the regular vial first, the nurse helps maintain the integrity of the vial and reduces the risk of creating a vacuum that would make it difficult to draw up the insulin.
- Withdrawing Insulin: After injecting air into the regular insulin vial, the nurse should then inject air into the NPH vial before withdrawing the NPH insulin. The correct sequence is crucial: always withdraw the short-acting insulin (regular) before the intermediate-acting insulin (NPH). This prevents contamination of the short-acting insulin with the longer-acting insulin.
- Withdrawing Insulin: After injecting air into both vials, the nurse should withdraw the regular insulin first. This is done by inverting the vial and drawing up the necessary units of insulin. After that, the nurse would follow the same process for the NPH insulin.
- Administering the Mixture: Once both insulins are drawn up in the same syringe, the nurse can proceed to administer the mixture to the client. It’s essential to ensure that the mixture is clear and uniform before administration.
By following this process, the nurse minimizes the risk of contamination and ensures accurate dosing of insulin for the client with diabetes mellitus.