Question

Calculate the dosage of insulin where necessary, and shade the dosage on the syringe provided. Labels have been provided for some problems. Order: Novolin R U-100 21 units subcut and Novolin N U-100 35 units subcut daily at \(7: 30 \mathrm{AM}\)

Short answer

Inject 21 units of Novolin R and 35 units of Novolin N at 7:30 AM.

Step-by-step solution

Understand the Insulin Types

First, we recognize that the problem involves two types of insulin: Novolin R and Novolin N. Novolin R is a short-acting insulin, whereas Novolin N is an intermediate-acting insulin. This is important for understanding how they will affect blood sugar levels and timing.

Determine the Dosage for Each Insulin

The order in the exercise specifies two dosages to be administered subcutaneously: Novolin R U-100 at 21 units and Novolin N U-100 at 35 units. Ensure these dosages are correctly interpreted from the prescription.

Prepare the Syringe for Novolin R

Using a U-100 insulin syringe, draw exactly 21 units of Novolin R insulin. It's crucial to correctly measure the units on the syringe to ensure accurate dosing.

Prepare the Syringe for Novolin N

Similarly, using another U-100 insulin syringe, draw exactly 35 units of Novolin N insulin. Double-check the measurement to ensure the patient receives the correct dosage.

Administer the Insulin Injections

At 7:30 AM, administer both insulin doses subcutaneously, following proper injection techniques. Typically, insulin is injected into areas with fatty tissue like the abdomen, avoiding veins and muscles.

Key concepts

Subcutaneous Injection

A subcutaneous injection is a method to administer medication into the layer of fat just underneath the skin. This mode of injection is chosen for medications like insulin that are absorbed slowly by the body.
To perform a subcutaneous injection for insulin:

• Select a clean injection site, commonly the abdomen, the upper arm, or thigh.
• Clean the area with alcohol swab to ensure it's free from bacteria.
• Pinch the skin lightly to lift the fat tissue away from the muscle.
• Insert the insulin syringe at a 45- or 90-degree angle, depending on the thickness of the skin.
• Push the plunger gently to inject the insulin.
• Remove the needle and apply light pressure to minimize bruising.

This method helps achieve optimal absorption of insulin, preventing erratic uptake and ensuring that blood sugar levels are controlled effectively.

Short-Acting Insulin

Short-acting insulin, also known as regular insulin, is designed to control blood sugar levels during meals. It begins to work relatively quickly compared to other insulin types. For the exercise in focus, the Novolin R is a short-acting insulin prescribed.
Key characteristics of short-acting insulin include:

• Begins to take effect within 30 minutes after injection.
• Peaks in about 2 to 4 hours.
• Lasts for about 4 to 8 hours.

Understanding short-acting insulin's timeline is crucial for timing meals and ensuring it prevents blood sugar spikes effectively. Administering it at the correct time, such as shortly before meals, helps to mimic the body's natural insulin response.

Intermediate-Acting Insulin

Intermediate-acting insulin, such as Novolin N, is formulated to maintain blood sugar control throughout the day or overnight. It's beneficial for maintaining baseline insulin levels between meals.
Here are some features of intermediate-acting insulin:

• Starts to work in about 1 to 2 hours after injection.
• Reaches peak action around 4 to 12 hours later.
• Provides coverage for approximately 12 to 18 hours.

This type of insulin is often taken in combination with short-acting insulin to provide comprehensive blood sugar management. It's crucial to monitor the schedule and dosage closely to prevent hypo- or hyperglycemia, ensuring stable daily blood glucose levels.

Insulin Syringe Measurement

Accurate insulin syringe measurement is vital for delivering the correct insulin dose. Insulin syringes are typically marked in "units," which relate directly to the dosage specified by healthcare providers. For example, a U-100 insulin syringe is calibrated for insulin concentrations where 1 mL contains 100 units.
Steps to ensure correct syringe measurement:

• Verify you are using the appropriate syringe for the insulin concentration, such as U-100 for Novolin R and Novolin N.
• Hold the syringe with the numbers facing towards you for easy readability.
• Draw the insulin by matching the top of the plunger to the correct unit marking on the syringe.
• Double-check the measurement before injection to ensure accuracy.

Using the correct syringe and measurement technique prevents dosing errors, ensuring effective control of blood glucose levels and minimizing risks associated with incorrect insulin administration.