diabetestalk.net

Which Insulin Is Drawn First Cloudy Or Clear

How To Prepare Two Types Of Insulin In One Syringe

How To Prepare Two Types Of Insulin In One Syringe

A step-by-step guide to combine two types of insulin in a single syringe ​People with diabetes may be prescribed two types of insulin to be taken at the same time. To reduce the number of insulin injections, it is common to combine two types of insulin in a single syringe using r​apid-acting (clear) insulin with either an intermediate or a long-acting (​​cloudy) insulin.​ ​ ​ ​​ ​ ​ ​ ​ ​ ​Follow These Steps to Prepare the Injection: Prepare your supplies and remove the insulin vials from the fridge half an hour before your injection. Check their expiry dates. Discard the vial six weeks after opening or as per the manufacturer’s guide. Roll the vial of cloudy insulin (intermediate or long-acting insulin) until the white powder has dissolved. Do NOT shake the vial. Clean the rubber stopper of the insulin vials with an alcohol wipe or a cotton ball dipped in alcohol. Draw air into the syringe by pulling the plunger down. The amount of air drawn should be equal to the dose of cloudy insulin that you require. With the vial standing upright, insert the needle into the vial containing the cloudy insulin. Inject air into the vial and remove the needle. Repeat the steps with clear insulin. Draw air into the syringe that is equal to the dose of clear insulin you require. Insert the needle into the vial containing the clear insulin and inject air into the vial. Do NOT remove the needle. With the needle in the vial, turn the syringe and insulin vial upside down, and draw out your dose of clear insulin. Read the line markings on the syringe to make sure you have drawn the correct amount of insulin. Insert the needle back into the vial containing the cloudy insulin. Do NOT push the plunger. Turn the syringe and insulin vial upside down, and draw out y Continue reading >>

Short-acting Insulins

Short-acting Insulins

Comments: Best if administered 30 minutes before a meal. NPH: If Regular insulin is mixed with NPH human insulin, the Regular insulin should be drawn into the syringe first. Aspart Novolog : Compatible but NO support clinically for such a mixture.Draw up Novolog first before drawing up Regular Insulin. Lispro Humalog : Compatible but NO support clinically for such a mixture. Draw up Humalog first before drawing up Regular Insulin. Mixtures should not be administered intravenously. When mixing insulin in a syringe, draw up the quickest acting insulin first (e.g. draw up Humalog or Novolog before drawing up Regular Insulin, or draw up Regular insulin before Novolin N (NPH) or Lente insulin. Insulin is a polypeptide hormone that controls the storage and metabolism of carbohydrates, proteins, and fats. This activity occurs primarily in the liver, in muscle, and in adipose tissues after binding of the insulin molecules to receptor sites on cellular plasma membranes. Insulin promotes uptake of carbohydrates, proteins, and fats in most tissues. Also, insulin influences carbohydrate, protein, and fat metabolism by stimulating protein and free fatty acid synthesis, and by inhibiting release of free fatty acid from adipose cells. Insulin increases active glucose transport through muscle and adipose cellular membranes, and promotes conversion of intracellular glucose and free fatty acid to the appropriate storage forms (glycogen and triglyceride, respectively). Although the liver does not require active glucose transport, insulin increases hepatic glucose conversion to glycogen and suppresses hepatic glucose output. Even though the actions of exogenous insulin are identical to those of endogenous insulin, the ability to negatively affect hepatic glucose output differs on a unit p Continue reading >>

​insulin Syringe Preparation: How To Mix Short- And Intermediate-acting Insulin

​insulin Syringe Preparation: How To Mix Short- And Intermediate-acting Insulin

​Nurses from the Department of Specialty Nursing, Singapore General Hospital, a member of the SingHealth group, share the right way of mixing short-acting (clear) and intermediate-acting (cloudy) insulin for injection. How to mix short-acting (clear) insulin and intermediate-acting (cloudy) insulin Step 1: Roll and clean ​ Wash and dry your hands. Roll the cloudy (intermediate-acting) bottle of insulin between your palms 10 times gently. Do not shake vigorously. Clean the top of vial with an alcohol swab. Step 2: Add air to cloudy (intermediate-acting) insulin ​ Draw the required amount of air (equal to the dosage of cloudy insulin) into the insulin syringe. Inject air into the cloudy insulin vial. Do not draw out any insulin, and remove the syringe and needle. Step 3: Add air to clear (short-acting) insulin ​ Using the same syringe and needle, draw the required amount of air (equal to the dosage for clear insulin) into the insulin syringe. Inject air into the clear insulin vial. Step 4: Withdraw clear (short-acting) insulin first, then cloudy (intermediate-acting) insulin ​ With the insulin syringe and needle attached, turn the clear insulin bottle upside down, with the needle bevel within the insulin, withdraw the required amount of clear insulin into the syringe. Then do the same with the cloudy insulin. Always withdraw clear insulin first before withdrawing cloudy insulin. Ensure the total dose of clear and cloudy insulin is correct. If overdrawn, discard and repeat. "Not all types of insulin are suitable to be mixed. If in doubt, please check with your pharmacist or diabetes nurse educator," say nurses from the Department of Specialty Nursing, Singapore General Hospital (SGH), a member of the SingHealth group. Reminders: Look out for the expiry date on th Continue reading >>

Insulin Injection: Two Bottle Injection Instructions

Insulin Injection: Two Bottle Injection Instructions

Wash your hands. Pick up the CLOUDY bottle and turn it upside down. Roll the bottle gently between your hands to mix the insulin. Wipe the top of both (clear and cloudy) bottles with alcohol. Remove the caps from the top and bottom of the syringe. Pull the plunger down to the correct unit mark for your CLOUDY insulin dose as ordered. Insert the needle into the CLOUDY bottle. Push the plunger down to inject air into the CLOUDY bottle. Withdraw the empty syringe from the bottle. Set the bottle aside. Pull the plunger down to the correct unit mark for the CLEAR insulin dose as ordered. Insert the needle into the CLEAR bottle. Push the plunger down to inject air into the CLEAR bottle. Leave the needle in the bottle. Turn the bottle upside down with the needle in it. Pull the plunger down to the correct unit mark for the CLEAR insulin dose. Look for air bubbles in the syringe. If you see air bubbles in the syringe, push the insulin back into the bottle, and repeat steps 17 and 18. Pull the bottle away from the needle, and set aside the CLEAR bottle. Pick up the CLOUDY bottle of insulin. Turn the CLOUDY bottle upside down and push the needle into the bottle. Be very careful not to move the plunger. Pull the plunger down and withdraw the correct number of units for the CLOUDY insulin. The plunger should now be on the unit mark showing the total units of both the CLEAR and CLOUDY types of insulin. For example, 6 units of CLEAR insulin are already in the syringe. Add 14 units of CLOUDY insulin for a total of 20 units in the syringe. Pull the bottle away from the needle. Set both bottles on the table. Look for air bubbles in the syringe. If you see air bubbles, discard the dose and begin again. Set the syringe down. Do not let the needle touch anything. Pinch or spread the skin a Continue reading >>

Steps For Preparing A Mixed Dose Of Insulin

Steps For Preparing A Mixed Dose Of Insulin

Steps for Preparing a Mixed Dose of Insulin slide 1 of 9, Rolling the bottles gently, Step 1. Roll the insulin bottles (vials) gently between your hands. Roll the cloudy insulin bottle until all the white powder has dissolved. Rolling the bottle warms the insulin if you have been keeping the bottle in the refrigerator. The order in which you mix the clear (rapid- or short-acting) and cloudy (long-acting) insulin is important. slide 2 of 9, Cleaning the lids of the bottles, Step 2. Wipe the rubber lid of both insulin bottles with an alcohol wipe or a cotton ball dipped in alcohol. Let the alcohol dry. Note: If you are using a bottle for the first time, remove the protective cover from the rubber lid before cleaning. Drawing air into the syringe for the cloudy insulin dose slide 3 of 9, Drawing air into the syringe for the cloudy insulin dose, Step 3. Remove the plastic cap that covers the needle on your insulin syringe. Step 4. Pull the plunger back on your insulin syringe and draw air into the syringe equal to the number of units of cloudy insulin to be given. Forcing air into the cloudy insulin bottle slide 4 of 9, Forcing air into the cloudy insulin bottle, Step 5. Push the needle of the syringe into the rubber lid of the cloudy insulin bottle. Step 6. Push the plunger of the syringe to force the air into the bottle. This equalizes the pressure in the bottle when you later remove the dose of insulin. Step 7. Remove the needle from the bottle. Drawing air into the syringe for the clear insulin dose slide 5 of 9, Drawing air into the syringe for the clear insulin dose, Step 8. Pull the plunger of the syringe back and draw air into the syringe equal to the number of units of clear insulin to be given. Forcing air into the clear insulin bottle slide 6 of 9, Forcing air i Continue reading >>

Www.cardiosmart.org

Www.cardiosmart.org

Diabetes: How to Give a Mixed-Dose Insulin Shot Getting started • Gather your supplies. You will need an insulin syringe, your bottles of insulin, and an alcohol wipe or a cotton ball dipped in alcohol. Keep your supplies in a bag or kit so you can carry the supplies wherever you go. • Read and follow all instructions on the label, including how to store the insulin and how long it will last. • Wash your hands with soap and running water. Dry them well. How to prepare the shot 1. Roll the insulin bottles gently between your hands to warm the insulin. Roll the cloudy insulin bottle until the white powder has dissolved and the insulin is mixed. 2. Wipe the rubber lid of both insulin bottles with an alcohol wipe or a cotton ball dipped in alcohol. (If you are using a bottle for the first time, remove the protective cover over the rubber lid.) Let the alcohol dry before putting a needle into the insulin bottle. 3. Remove the plastic cap from the needle on your insulin syringe. Take care not to touch the needle. 4. Pull the plunger back on your insulin syringe, and draw air into the syringe equal to the number of units of cloudy insulin to be given. 5. Push the needle of the syringe into the rubber lid of the cloudy insulin bottle. Push the plunger of the syringe to force the air into the bottle. This equalizes the pressure in the bottle when you later remove the dose of insulin. Remove the needle from the bottle. 6. Pull the plunger of the syringe back and draw air into the syringe equal to the number of units of clear insulin to be given. 7. Push the syringe needle into the rubber lid of the clear insulin bottle. Push the plunger to force the air into the bottle. Leave the needle in place. 8. Turn the bottle and syringe upside down. Position the tip of th Continue reading >>

Why Is Insulin Drawn Clear To Cloudy?

Why Is Insulin Drawn Clear To Cloudy?

I have a question for my fellow nurses, one I have had since nursing school. A question I have asked fellow nurses throughout my nursing career with no answer to my question. A simple question of why, when drawing up two different insulin's is the clear(regular) drawn up before the cloudy (nph, lantus, etc.)? Is there any evidence based reasoning to this practice? From what I can understand, it is done so that the regular insulin is not contaminated by the cloudy insulin. IMO however, cloudy should be drawn up first. If I contaminate the clear insulin I will actually be able to visually tell because the bottle of clear insulin will turn cloudy. Yes, this means the bottle is now contaminated & must be disposed of but I much rather dispose of a bottle of insulin than give my patient the wrong dosage of medicine or NPH that was contaminated by regular insulin that I am unable to tell since I could pump a whole syringe full of regular into NPH & no-one would ever be able to tell. Also, regular is rapid onset & hits the body much harder & faster than the longer acting NPH. If a patient was to get a few extra units of NPH, likely the patient would be no worse for wear. At best, I might have to babysit them for a shift & monitor their levels. However, depending on a patients insulin sensitivity. 1-3 units of regular can drop a patient by 50-150. Maybe another nurse can help me out, because the best answer I have gotten is "its just the way it is done" I would really like to know the reasoning behind it. Thank's Continue reading >>

Steps For Preparing A Mixed Dose Of Insulin

Steps For Preparing A Mixed Dose Of Insulin

XIAFLEX® is a prescription medicine used to treat adults with Dupuytren's contracture when a "cord" can be felt. It is not known if XIAFLEX® is safe and effective in children under the age of 18. Do not receive XIAFLEX® if you have had an allergic reaction to collagenase clostridium histolyticum or any of the ingredients in XIAFLEX®, or to any other collagenase product. See the end of the Medication Guide for a complete list of ingredients in XIAFLEX®. XIAFLEX® can cause serious side effects, including: Tendon rupture or ligament damage. Receiving an injection of XIAFLEX® may cause damage to a tendon or ligament in your hand and cause it to break or weaken. This could require surgery to fix the damaged tendon or ligament. Call your healthcare provider right away if you have trouble bending your injected finger (towards the wrist) after the swelling goes down or you have problems using your treated hand after your follow-up visit Nerve injury or other serious injury of the hand. Call your healthcare provider right away if you get numbness, tingling, increased pain, or tears in the skin (laceration) in your treated finger or hand after your injection or after your follow-up visit Hypersensitivity reactions, including anaphylaxis. Severe allergic reactions can happen in people who receive XIAFLEX® because it contains foreign proteins. Call your healthcare provider right away if you have any of these symptoms of an allergic reaction after an injection of XIAFLEX®: hives swollen face breathing trouble chest pain low blood pressure Increased chance of bleeding. Bleeding or bruising at the injection site can happen in people who receive XIAFLEX®. Talk to your healthcare provider if you have a problem with your blood clotting. XIAFLEX® may not be right for you. Befor Continue reading >>

Master Mixing Nph And Regular Insulin For Injection With Picmonic For Nursing Rn

Master Mixing Nph And Regular Insulin For Injection With Picmonic For Nursing Rn

With Picmonic, facts become pictures. We've taken what the science shows - image mnemonics work - but we've boosted the effectiveness by building and associating memorable characters, interesting audio stories, and built-in quizzing. Mixing Neil-Patrick-Harris-vial and Regular-vial with Insect-syringe Picmonic Mixing two types of insulin for injection such as regular insulin, which is short acting and NPH insulin, which has a moderate peak of action is often indicated for patients who chronically require insulin therapy. To prevent contamination from multi-use vials the nurse must be familiar with the procedure and special considerations when combining two types of insulin in one syringe for injection. Ace Your Nursing (RN) School Classes & Exams with Picmonic: Picture Mnemonics for Fundamentals of Nursing, 8th Ed. Potter, Perry, Stockert & Hall, 2013 Picmonic for Nursing (RN) covers information that is relevant to your entire Nursing (RN) education. Whether you’re studying for your classes or getting ready to conquer your NCLEX®-RN, Hesi, ATI, TEAS test, Kaplan exams, we’re here to help. "Bravo Team Picmonic on creating a truly revolutionary approach to learning, and for helping me to pass the NCLEX®. Couldn’t have done it without you!" — Steph B., University of Detroit Mercy, class of 2015 TRY IT FREE Continue reading >>

Steps To Mix Insulin

Steps To Mix Insulin

Steps to mix insulin 1. Wash hands 2. Gently rotate NPH insulin bottle 3. Wipe off tops of insulin vials with alcohol wipe 4. Draw back amount of air into the syringe that equals total dose 5. Inject air equal to NPH dose into NPH vial. 6. Inject air equal to regular dose into regular vial 7. Invert regular insulin bottle and withdraw regular insulin dose 8. Without adding more air to NPH vial, carefully withdraw NPH dose. Continue reading >>

Insulin: How To Give A Mixed Dose

Insulin: How To Give A Mixed Dose

Many people with diabetes need to take insulin to keep their blood glucose in a good range. This can be scary for some people, especially for the first time. The truth is that insulin shots are not painful because the needles are short and thin and the insulin shots are placed into fatty tissue below the skin. This is called a subcutaneous (sub-kyu-TAY-nee-us) injection. In some cases, the doctor prescribes a mixed dose of insulin. This means taking more than one type of insulin at the same time. A mixed dose allows you to have the benefits of both short-acting insulin along with a longer acting insulin — without having to give 2 separate shots. Usually, one of the insulins will be cloudy and the other clear. Some insulins cannot be mixed in the same syringe. For instance, never mix Lantus or Levemir with any other solution. Be sure to check with your doctor, pharmacist, or diabetes educator before mixing. These instructions explain how to mix two different types of insulin into one shot. If you are giving or getting just one type of insulin, refer to the patient education sheet Insulin: How to Give a Shot. What You Will Need Bottles of insulin Alcohol swab, or cotton ball moistened with alcohol Syringe with needle (You will need a prescription to buy syringes from a pharmacy. Check with your pharmacist to be sure the syringe size you are using is correct for your total dose of insulin.) Hard plastic or metal container with a screw-on or tightly-secured lid Parts of a Syringe and Needle You will use a syringe and needle to give the shot. The parts are labeled below. Wash the work area (where you will set the insulin and syringe) well with soap and water. Wash your hands. Check the drug labels to be sure they are what your doctor prescribed. Check the expiration date o Continue reading >>

Types Of Insulin

Types Of Insulin

Topic Overview Insulin is used to treat people who have diabetes. Each type of insulin acts over a specific amount of time. The amount of time can be affected by exercise, diet, illness, some medicines, stress, the dose, how you take it, or where you inject it. Insulin strength is usually U-100 (or 100 units of insulin in one millilitre of fluid). Short-acting (regular) insulin is also available in U-500. This is five times more concentrated than U-100 regular insulin. Long-acting insulin (glargine) is also available in U-300. This is three times more concentrated than U-100 long-acting insulin. Be sure to check the concentration of your insulin so you take the right amount. Insulin is made by different companies. Make sure you use the same type of insulin consistently. Types of insulinfootnote 1 Type Examples Appearance When it starts to work (onset) The time of greatest effect (peak) How long it lasts (duration) Rapid-acting Apidra (insulin glulisine) Clear 10-15 minutes 1-1.5 hours 3-5 hours Humalog (insulin lispro) Clear 10-15 minutes 1-2 hours 3.5-4.75 hours NovoRapid (insulin aspart) Clear 10-15 minutes 1-1.5 hours 3-5 hours Short-acting Humulin R, Novolin ge Toronto (insulin regular) Clear 30 minutes 2-3 hours 6.5 hours Intermediate-acting Humulin N, Novolin ge NPH(insulin NPH) Cloudy 1-3 hours 5-8 hours Up to 18 hours Long-acting Lantus (insulin glargine) Clear 1.5 hours Does not apply Up to 24 hours Levemir (insulin detemir) Clear 1.5 hours Does not apply 16 to 24 hours Toujeo (insulin glargine U-300) Clear Up to 6 hours Does not apply Up to 30 hours Rapid-acting insulins work over a narrow, more predictable range of time. Because they work quickly, they are used most often at the start of a meal. Rapid-acting insulin acts most like insulin that is produced by Continue reading >>

Insulin Basics | Ce Article | Nursingcenter

Insulin Basics | Ce Article | Nursingcenter

May/June 2017, Volume 15 Number 3 , p 30 - 35 This article has an associated Continuing Education component. Keep your patients safe with this must-know information. Over 29 million Americans have diabetes, according to the CDC. Another 86 million have prediabetes. Of these individuals, it's estimated that approximately 6 million take insulin. Administration of this medication carries some significant safety risks. We discuss these safety concerns and your role in patient monitoring and education. But first, let's review insulin's role in the body and the types of insulin available. Insulin is an essential hormone produced and secreted by the pancreas that helps cells use glucose for energy. Inside the pancreas are clusters of cells known as islets. Beta cells within the islets are responsible for making insulin and releasing it into the bloodstream. When a person eats carbohydrates, the body breaks them down into the simple sugar glucose, which is then used as the body's main energy source. As circulating glucose levels in the bloodstream rise, the pancreas releases insulin, which helps the glucose enter the cells. When insulin is released into the bloodstream, it comes into contact with the cell membrane and combines with a receptor that allows glucose transporters to be activated. Think of insulin as the key that opens up the cell so that glucose can enter. With type 1 diabetes mellitus, the body doesn't make insulin because the beta cells within the pancreas have been destroyed. These individuals require insulin administration for the rest of their lives. With type 2 diabetes mellitus, insulin is made in the pancreas, but the body doesn't respond well to it. These individuals may require an oral medication, insulin, or a combination of both. Be aware that insulin c Continue reading >>

My Doctor Says I Need To Mix Insulins...

My Doctor Says I Need To Mix Insulins...

Mixing Insulins BD Getting Started ™ My Doctor Says I Need to Mix Insulins... How Do I Begin? When your doctor tells you to use two types of insulin for an injection, they can be mixed in the same insulin syringe so that you will need only one injection. Using two types of insulin can help you keep your blood sugar levels in your target range. When you mix two insulins in one syringe, one type of insulin is always clear and short or rapid-acting, while the other type is cloudy and long-acting. Check that you have the right syringe size. Match your dose to the syringe size that is just right for you. It is an easy way to assure the accuracy of your dosage. Two types of Insulin BD™ Insulin Syringe BD™ Alcohol Swabs To mix your insulins, you will need:To mix your insulins, you will need: Also check that you have the right brand and type of insulin. Make sure that the expiration date on the insulin bottle has not passed. Between 30 and 50 units Between 50 and 100 units Use a 3/10 cc BD INSULIN SYRINGE Use a 1/2 cc BD INSULIN SYRINGE Use a 1 cc BD INSULIN SYRINGE Less than 30 units at one time - - - 1 2 3 if you inject:if you inject: ml ml ml 1 2 3 •Roll the bottle between your hands. •Never shake a bottle of insulin. •Wipe the top of both the insulin bottles with a BD™ ALCOHOL SWAB. step one...step one... step two...step two... step three...step three... •Wash your hands. 4 •Pull the plunger down to let _____ units of air in your syringe. •You need air in the syringe equal to the amount of cloudy insulin you will take. step four...step four... 5 6 7 8 •Push the air into the cloudy insulin bottle. •Pull the needle out of the cloudy insulin bottle. •You are not going to draw out any of the cloudy in Continue reading >>

Giving Yourself An Insulin Shot For Diabetes

Giving Yourself An Insulin Shot For Diabetes

For those with diabetes, an insulin shot delivers medicine into the subcutaneous tissue -- the tissue between your skin and muscle. Subcutaneous tissue (also called "sub Q" tissue) is found throughout your body. Please follow these steps when using an insulin syringe. Note: these instructions are not for patients using an insulin pen or a non-needle injection system. Select a clean, dry work area, and gather the following insulin supplies: Bottle of insulin Sterile insulin syringe (needle attached) with wrapper removed Two alcohol wipes (or cotton balls and a bottle of rubbing alcohol) One container for used equipment (such as a hard plastic or metal container with a screw-on or tightly secured lid or a commercial "sharps" container) Wash hands with soap and warm water and dry them with a clean towel. Remove the plastic cap from the insulin bottle. Roll the bottle of insulin between your hands two to three times to mix the insulin. Do not shake the bottle, as air bubbles can form and affect the amount of insulin withdrawn. Wipe off the rubber part on the top of the insulin bottle with an alcohol pad or cotton ball dampened with alcohol. Set the insulin bottle nearby on a flat surface. Remove the cap from the needle. If you've been prescribed two types of insulin to be taken at once (mixed dose), skip to the instructions in the next section. Draw the required number of units of air into the syringe by pulling the plunger back. You need to draw the same amount of air into the syringe as insulin you need to inject. Always measure from the top of the plunger. Insert the needle into the rubber stopper of the insulin bottle. Push the plunger down to inject air into the bottle (this allows the insulin to be drawn more easily). Leave the needle in the bottle. Turn the bottle an Continue reading >>

More in insulin