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 >>
How To Mix Insulin Clear To Cloudy
Learn how to mix insulin clear to cloudy. Drawing up and mixing insulin is a skill that nurses will utilize on the job. Insulin is administered to patients who have diabetes . These type of patientsdepend on insulin so their body can use glucose. Therefore, nurses must be familiar with how to mix insulin. The goal of this article is to teach you how to mix insulin. Below are a video demonstration and step-by-step instructions on how to do this. Purpose of mixing insulin: To prevent having to give the patient two separate injections (hence better for the patient). Most commonly ordered insulin that are mixed: NPH (intermediate-acting) and Regular insulin (short-acting). Never mix Insulin Glargine Lantus with any other type of insulin. Administer the dose within 5 to 10 minutes after drawing up because the regular insulin binds to the NPH and this decreases its action. Check the patients blood sugar and for signs and symptoms of hypoglycemia to ensure they arent hypoglycemic if patient is hypoglycemic hold the dose and notify md for further orders. Key Concept for Mixing Insulin: Draw up CLEAR TO CLOUDY Remember the mnemonic: RN (Regular to Nph) Why? It prevents contaminating the vial of clear insulin with the cloudy insulin because if contaminated it can affect the action of the insulin. Why does this matter because they will be mixed in the syringe? You have 5 to 10 minutes to give the insulin mixed in the syringe before the action of the insulins are affected Demonstration on Drawing Up Clear to Cloudy Insulin 1. Check the doctors order and that you have the correct medication: Doctors order says: 10 units of Humulin R and 12 units of Humulin N subcutaneous before breakfast daily Youre giving a total of 22 units (10 Regular & 12 NPH) As the nurse, it is important to k Continue reading >>
Combining Insulin
See also diluting insulin and injecting insulin. For how to agitate, see rolling insulin. For insulins that can't be diluted, see fine doses. "Combining" insulins refers to mixing them in a single syringe before injecting. BD has animated videos[1] with narrations that show you how to combine two insulins in the same syringe. It is certainly possible to use insulins "not to be combined" by giving separate injections of them instead. The problem regarding those "not to be combined" in the same syringe has to do with their chemical reactions to each other--not to how they work in the body. Always follow medical advice when using more than one insulin, combined in one syringe or injected separately. An easy way to remember which insulin is to be drawn first is "clear before cloudy", meaning that the first insulin to draw is always the short-acting clear one. Another memory help is the fastest-acting insulin is to be drawn first. The suspended cloudy one always goes last. The reason why you are to inject air equal to the unit dose into the cloudy insulin vial first and to draw insulin from it last, is to avoid the possibility of any cloudy insulin going into the short-acting insulin vial. Having this happen could alter the pharmacodynamic properties of the clear, short-acting one[2]. This could "lengthen" the effects of the fast-acting insulin, causing it to behave differently. Some insulins, Lantus and Levemir among them, cannot be combined, according to the manufacturers. Both insulins have unique mechanisms of action. Lantus does not form crystals until after it's been injected under the skin. Its pH balance is acid (unlike all other insulins which are pH balanced neutral); the crystal formation occurs when the acid Lantus meets the pH neutral skin. Changing the balance Continue reading >>
Proper Use
Drug information provided by: Micromedex Make sure you have the type (beef and pork, pork, or human) and the strength of insulin that your doctor ordered for you. You may find that keeping an insulin label with you is helpful when buying insulin supplies. The concentration (strength) of insulin is measured in USP Insulin Units and USP Insulin Human Units and is usually expressed in terms such as U-100 insulin. Insulin doses are measured and injected with specially marked insulin syringes. The appropriate syringe is chosen based on your insulin dose to make measuring the dose easy to read. This helps you measure your dose accurately. These syringes come in three sizes: 3/10 cubic centimeters (cc) measuring up to 30 USP Units of insulin, ½ cc measuring up to 50 USP Units of insulin, and 1 cc measuring up to 100 USP Units of insulin. It is important to follow any instructions from your doctor about the careful selection and rotation of injection sites on your body. There are several important steps that will help you successfully prepare your insulin injection. To draw the insulin up into the syringe correctly, you need to follow these steps: Wash your hands with soap and water. If your insulin contains zinc or isophane (normally cloudy), be sure that it is completely mixed. Mix the insulin by slowly rolling the bottle between your hands or gently tipping the bottle over a few times. Never shake the bottle vigorously (hard). Do not use the insulin if it looks lumpy or grainy, seems unusually thick, sticks to the bottle, or seems to be even a little discolored. Do not use the insulin if it contains crystals or if the bottle looks frosted. Regular insulin (short-acting) should be used only if it is clear and colorless. Remove the colored protective cap on the bottle. Do not Continue reading >>
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 >>
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 >>
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 >>
Mixing Insulin
License Here How Do You Mix Insulin? Your doctor or diabetes educator may ask you to mix a short-acting or clear insulin with an intermediate or long acting cloudy insulin in the same syringe so that both can be given at the same time. Keep in mind: The only insulin that cannot be mixed is insulin Glargine. Mixing Insulin In this example, the doctor has asked you to mix 10 units of regular, clear, insulin with 15 units of NPH cloudy insulin, to a total combined dose of 25 units. Always, draw “clear before cloudy” insulin into the syringe. This is to prevent cloudy insulin from entering the clear insulin bottle. Always do this procedure in the correct order, as shown in the following sequence. Roll the bottle of the cloudy insulin between your hands to mix it. Clean both bottle tops with an alcohol wipe. Pull back the plunger of the syringe to the dose of the long-acting (cloudy) insulin in this example 15 units. You now have 15 units of air in the syringe. Check the insulin bottle to ensure you have the correct cloudy type of insulin. With the insulin bottle held firmly on a counter or tabletop, insert the needle through the rubber cap into the bottle. Push the plunger down so that the air goes from the syringe into the bottle. Remove the needle and syringe. This primes the bottle for when you withdraw the insulin later. Pull back the plunger of the syringe to the dose of the shorter acting clear insulin in this example 10 units. You now have 10 units of air in the syringe. Check the insulin bottle to ensure you have the correct clear type of insulin. With the insulin bottle held firmly on a counter or tabletop, insert the needle through the rubber cap into the bottle. Push the plunger down so that the air goes from the syringe into the bottle. Turn the bottle upsid Continue reading >>
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 >>
Insulin Administration
Insulin is necessary for normal carbohydrate, protein, and fat metabolism. People with type 1 diabetes mellitus do not produce enough of this hormone to sustain life and therefore depend on exogenous insulin for survival. In contrast, individuals with type 2 diabetes are not dependent on exogenous insulin for survival. However, over time, many of these individuals will show decreased insulin production, therefore requiring supplemental insulin for adequate blood glucose control, especially during times of stress or illness. An insulin regimen is often required in the treatment of gestational diabetes and diabetes associated with certain conditions or syndromes (e.g., pancreatic diseases, drug- or chemical-induced diabetes, endocrinopathies, insulin-receptor disorders, certain genetic syndromes). In all instances of insulin use, the insulin dosage must be individualized and balanced with medical nutrition therapy and exercise. This position statement addresses issues regarding the use of conventional insulin administration (i.e., via syringe or pen with needle and cartridge) in the self-care of the individual with diabetes. It does not address the use of insulin pumps. (See the American Diabetes Association’s position statement “Continuous Subcutaneous Insulin Infusion” for further discussion on this subject.) INSULIN Insulin is obtained from pork pancreas or is made chemically identical to human insulin by recombinant DNA technology or chemical modification of pork insulin. Insulin analogs have been developed by modifying the amino acid sequence of the insulin molecule. Insulin is available in rapid-, short-, intermediate-, and long-acting types that may be injected separately or mixed in the same syringe. Rapid-acting insulin analogs (insulin lispro and insulin a Continue reading >>
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 >>
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 >>
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 >>
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 rapid-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
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 >>
