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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
To find the milligrams per minute, you need to calculate the following:
- The volume of Lopressor in milliliters
- The infusion rate in milliliters per minute using the formula: Infusion rate (mL/min) = Total volume (mL) / Time (min)
- The dose of Lopressor in milligrams per minute using the formula: Dose (mg/min) = Infusion rate (mL/min) x Concentration (mg/mL)
First, divide the dose of Lopressor by the concentration to get the volume in milliliters:
5 mg / 1 mg/mL = 5 mL
Next, use the formula for infusion rate to find how many milliliters per minute the IV pump should deliver:
Infusion rate (mL/min) = Total volume (mL) / Time (min)
Since the total volume is 5 mL and the time is 2 minutes, plug in these values into the formula:
Infusion rate (mL/min) = 5 mL / 2 min
Simplify and solve for the infusion rate:
Infusion rate (mL/min) = 2.5 mL/min
Then, use the formula for dose to find how many milligrams per minute the patient should receive:
Dose (mg/min) = Infusion rate (mL/min) x Concentration (mg/mL)
Since the infusion rate is 2.5 mL/min and the concentration is 1 mg/mL, plug in these values into the formula:
Dose (mg/min) = 2.5 mL/min x 1 mg/mL
Simplify and solve for the dose:
Dose (mg/min) = 2.5 mg/min
Therefore, the patient should receive **2.5 mg/min** of Lopressor.
Correct Answer is A
Explanation
To calculate the infusion rate, we need to convert the patient's weight from kilograms to milligrams.
Patient's weight: 65 kg
Dose required: 200 mcg/kg/min
First, let's calculate the total dose required for the patient per minute: Dose required = 200 mcg/kg/min * 65 kg
= 13,000 mcg/min
Next, we need to convert the dose from micrograms to milligrams:
13,000 mcg/min = 13 mg/min
Now, let's determine the infusion rate. We have 2,500 mg of esmolol in 250 mL of fluid. Therefore, the concentration of esmolol in the fluid is:
Concentration = 2,500 mg / 250 mL
= 10 mg/mL
To find the infusion rate, we divide the dose required by the concentration: Infusion rate = 13 mg/min / 10 mg/mL
= 1.3 mL/mi
Since the options are in mL/hr, we need to convert the rate from mL/min to mL/hr:
1.3 mL/min * 60 min/hr = 78 mL/hr
Therefore, the correct answer is:
a. 78 mL/hr
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