PN Adult Medical Surgical Practice Exam

When preparing a mixed insulin regimen, what should the nurse do first?

1. Inject air into the NPH vial after withdrawing regular insulin

2. Withdraw both types of insulin and then add air to the syringe

3. Gently shake the NPH insulin

4. Withdraw the regular insulin before the NPH insulin

The correct answer is: Withdraw the regular insulin before the NPH insulin

When preparing a mixed insulin regimen, the first step should be to withdraw the regular insulin before the NPH insulin. This sequence is critical for ensuring that there is no contamination and for maintaining the effectiveness of both types of insulin. Regular insulin is a clear solution, while NPH insulin is a cloudy solution that requires careful handling. By drawing up the regular insulin first, it prevents any potential cross-contamination of the clear insulin by the cloudy one. Furthermore, it's essential to remember that regular insulin should always be drawn into the syringe before the NPH insulin, as this practice allows for accurate dosing and maintains the integrity of the regular insulin, which acts more rapidly compared to the intermediate-acting NPH. Effective mixed insulin preparation is vital for optimal glycemic control in patients with diabetes, ensuring that both fast-acting and longer-acting insulin are administered correctly.