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 N U-100 48 units subcut and Humulin R U-100 30 units subcut a.c. \(7: 30 \mathrm{AM}\)

Short answer

Administer 48 units of Humulin N and 30 units of Humulin R using a U-100 syringe.

Step-by-step solution

Understanding the Order

The order requires administering two types of insulin: Humulin N and Humulin R. The specified doses are 48 units of Humulin N and 30 units of Humulin R. Both are measured in U-100 concentration, meaning each 1 mL contains 100 units of insulin.

Labeling the Syringe

We will use a U-100 insulin syringe capable of measuring up to 100 units. Our task is to correctly label and shade the units on the syringe for visibility, first addressing Humulin N and then Humulin R inside separate syringes or compartments if necessary.

Shading Humulin N Dosage

On the syringe, locate the graduations marking units from 0 to 100. Shade up to the 48-unit mark to indicate the amount of Humulin N to be drawn into the syringe.

Shading Humulin R Dosage

Similarly, on a separate syringe or after administering Humulin N, locate the marks from 0 to 100 and shade up to the 30-unit mark to indicate the Humulin R dosage.

Confirming the Dosage

Verify that Humulin N is shaded to the 48-unit mark and Humulin R to the 30-unit mark, ensuring accuracy in the preparation of the insulin dosage before administration. Consider any pharmacological guidelines or protocols in a medical setting for any additional safety checks before injections.

Key concepts

Humulin N

Humulin N is an intermediate-acting insulin. It's designed to start working a few hours after injection and lasts for about 12 to 18 hours. This makes it helpful for managing blood sugar levels throughout the day, and it is often administered once or twice a day.
Humulin N is part of the NPH (neutral protamine Hagedorn) insulin group, named for the way it's formulated to release more slowly into the bloodstream. Because it releases at a steady pace, Humulin N can help keep blood sugar levels stable.

• Action Peak: Humulin N peaks about 4 to 12 hours after injection.
• Duration: The effects can last up to 18 hours.

Humulin N typically comes in a U-100 concentration, meaning there are 100 units of insulin per milliliter of liquid. This concentration is crucial for dosing accuracy, especially when using a U-100 syringe.

Humulin R

Humulin R is a short-acting insulin, known for its rapid action. It's usually taken around meal times to help manage the rise in blood sugar that occurs after eating. It starts working about 30 minutes after injection, peaks between 2 to 4 hours, and its effects last for 5 to 8 hours.
Humulin R is often used in situations requiring quick adjustment of blood glucose, such as before meals or in an emergency glucose level correction.
Like Humulin N, Humulin R also comes in a U-100 concentration, ensuring the correct amount of insulin can be dosed accurately with a U-100 insulin syringe.

• Fast-acting: Starts lowering blood sugar 30 minutes after injection.
• Peak time: Most effective between 2 and 4 hours post-injection.

Humulin R is essential for managing mealtime blood glucose spikes and is a fundamental part of many insulin regimens.

Subcutaneous Injection

Subcutaneous injection is a method used to deliver medications, such as insulin, into the layer of skin directly below the dermis and epidermis. Insulin is commonly administered this way because it allows the medication to be absorbed slowly over time.

Here's how subcutaneous injections work:

• They are usually administered in fatty areas such as the abdomen, thigh, or back of the arm.
• To perform, you use a short, thin needle to gently penetrate the skin layer.

This delivery method creates a slow, steady release of insulin, which is beneficial for maintaining stable blood glucose levels. It is generally less painful and considered safer, which is why it is the preferred method for insulin administration. Patients often rotate injection sites to avoid deterioration of the skin and ensure even absorption of insulin.

U-100 Insulin Syringe

The U-100 insulin syringe is specifically designed for use with U-100 insulin, which contains 100 units of insulin per milliliter. This syringe allows for precise dosing, which is crucial for effective diabetes management.

Key features of the U-100 syringe:

• Graduated markings that provide clear guidance on insulin dosage, typically marked at every single-unit increment.
• An insulin-specific design that includes finer needles and dosing measurements, optimized for accuracy and comfort.

When preparing insulin dosages such as Humulin N or Humulin R, it's essential to use a U-100 syringe to avoid potentially harmful dosing errors. This specificity in insulin delivery helps ensure patient safety, providing peace of mind for both users and healthcare professionals in managing insulin therapy.