Question

Calculate the dosage of insulin where necessary, and shade the dosage on the syringe provided. Labels have been provided for some problems. Order: Humulin R U-100 10 units subcut and Humulin N U-100 15 units subcut a.c. \(7: 30 \mathrm{AM}\)

Short answer

Administer a total of 25 units, with 10 units of Humulin R and 15 units of Humulin N.

Step-by-step solution

Understand the Medication Order

The doctor has ordered two types of insulin: Humulin R and Humulin N. Humulin R U-100 is 10 units and Humulin N U-100 is 15 units, both to be administered subcutaneously before breakfast (a.c. at 7:30 AM).

Identify Dosage Concentration

The concentration for both types of insulin is U-100. This means there are 100 units of insulin per milliliter. Therefore, both insulins should be drawn up to their specific unit amounts based on the order.

Calculate Total Insulin Units

Add together the units from both Humulin R and Humulin N. Humulin R is 10 units and Humulin N is 15 units. Therefore, the total insulin units to be administered are 10 + 15 = 25 units.

Prepare the Syringe

Using a U-100 syringe, draw up 10 units of Humulin R first, as it is clear insulin and should be drawn first to avoid contamination. Then draw up 15 units of Humulin N, which is cloudy, making the total volume in the syringe 25 units.

Shade the Syringe

On the syringe diagram, shade up to the 25-unit mark. Make sure the marks are clear, and label the mixture as a combination of Humulin R and Humulin N.

Verify the Dosage and Preparation

Double-check that the syringe contains a total of 25 units – 10 units of clear Humulin R and 15 units of cloudy Humulin N. Ensure that it is ready for administration subcutaneously as per the order.

Key concepts

Insulin Administration

Administering insulin is a critical task for managing diabetes. It involves giving a precise dose tailored to the individual, often several times a day. Here's a simplified breakdown of an insulin administration process:

• First, understand the type of insulin required. Insulin comes in various types, such as Humulin R and Humulin N, each having different onset and duration of action.
• It's vital to follow the doctor's instructions accurately. The prescription may specify the type, dosage, and time of day for administration.

The goal is to maintain stable blood glucose levels. Administering the wrong dose or type can lead to hypo- or hyperglycemia. Double-checking the insulin type and dosage with the order is essential. In our scenario, the patient requires 10 units of Humulin R and 15 units of Humulin N before breakfast. Consistency and accuracy help in managing the patient’s diabetes effectively.

U-100 Insulin Concentration

Understanding insulin concentration is key to ensuring safe and effective diabetes management. U-100 insulin is a standard concentration used worldwide.

• "U-100" means there are 100 units of insulin in every milliliter (mL) of the solution. This factor simplifies dosage calculations and ensures accurate delivery of the required insulin units.
• When handling U-100 insulin, it is crucial to employ a corresponding syringe specially designed to measure the units accurately, rather than the volume in mL.

This standardization reduces errors in insulin preparation and administration. In our exercise, both Humulin R and Humulin N are specified in U-100 concentration, which makes it easier to calculate and administer the insulin dosage accurately.

Subcutaneous Injection

A subcutaneous injection involves administering medication into the fatty tissue just below the skin. It's often used for insulin delivery since this layer has fewer blood vessels, allowing for a slow, steady absorption of the drug.

• It’s important to choose the correct site for injection. Common sites include the abdomen, upper arms, and thighs. Rotating these sites is necessary to prevent tissue damage and ensure consistent insulin absorption.
• The technique involves pinching the skin, inserting the needle at a 45 to 90-degree angle, depending on needle length and site, and injecting the medication steadily.

The process is mostly painless, although practicing proper hygiene by cleaning the injection site is critical. Following these steps carefully ensures that insulin is delivered into the subcutaneous tissue as intended, aiding effective glucose management.

Syringe Preparation

Preparing the syringe properly is a vital part of insulin administration.

• Begin by selecting a U-100 insulin syringe, which is specifically calibrated for U-100 insulin, ensuring precise unit measurements.
• To avoid cross-contamination, draw up clear insulin first (in this case, Humulin R), followed by the cloudy insulin (Humulin N). Note that after injecting Humulin R, the syringe should read 10 units, and after adding Humulin N, it should show a total of 25 units.

This technique helps maintain the integrity of the insulin types. Make sure to remove any air bubbles from the syringe before proceeding with the injection. This preparation is crucial for accurate dosage and effective insulin administration. Double-checking that the syringe contains the correct total dosage is the final step before administration.