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 42 units subcut at 4:30 PM.

Short answer

Draw 10 units of Humulin R and 42 units of Humulin N using a U-100 syringe.

Step-by-step solution

Understanding the Dosage Order

The order specifies two types of insulin: Humulin R U-100 with a dosage of 10 units, and Humulin N U-100 with a dosage of 42 units. Both are to be administered subcutaneously at 4:30 PM.

Identifying the Syringe Type

Since both insulin types are U-100, a U-100 insulin syringe must be used. The markings on this syringe are calibrated for U-100 insulin, meaning 1cc holds 100 units of insulin.

Drawing Humulin R

Using the U-100 syringe, draw 10 units of Humulin R insulin. This is typically the fast-acting insulin and is administered first.

Drawing Humulin N

Next, draw 42 units of Humulin N insulin using the same syringe. Humulin N is an intermediate-acting insulin. If both insulins are being combined in one syringe, ensure proper technique is followed—Humulin R should be drawn up before Humulin N if mixed.

Administering the Insulin

Double-check the patient's insulin needs and confirm the time of administration (4:30 PM). Inject the insulin subcutaneously as prescribed.

Key concepts

Subcutaneous Injection Administration

Subcutaneous injection administration is a method of delivering medication into the tissue layer between the skin and muscle. This method is commonly used for insulin injections due to its ease and effectiveness.

When administering a subcutaneous injection, it is important to select the proper site. Common injection sites include the abdomen, thigh, or upper arm. Rotating these sites is crucial to avoid tissue damage or the formation of hardened areas.

Before administering, ensure the skin is clean. Gently pinch the skin to create a small "tent". Insert the needle at a 45 to 90-degree angle, depending on the fat layer present. Slowly inject the insulin, then withdraw the needle smoothly and apply gentle pressure with gauze without rubbing. Always dispose of needles in a proper sharps container to ensure safety.

Types of Insulin

Different types of insulin are used to manage blood sugar levels depending on how quickly and how long they work. The main categories include:

• Rapid-acting insulin: Begins working within 15 minutes and lasts up to 5 hours. Examples include insulin lispro and insulin aspart.
• Short-acting insulin: Takes about 30 minutes to start working and lasts 6 to 8 hours. Humulin R is a common example.
• Intermediate-acting insulin: Starts working within 1 to 4 hours and can last up to 18 hours. An example is Humulin N.
• Long-acting insulin: Begins working within a few hours and provides a steady level of insulin over 24 hours without peaks. Insulin glargine is an example.

Each type of insulin plays a unique role in handling the body’s insulin requirements. The combination of Humulin R and Humulin N provides both immediate and extended control of blood sugar levels, which is useful for many patients.

U-100 Insulin Syringe

A U-100 insulin syringe is specifically designed for insulin that has a concentration of 100 units per milliliter (ml). These syringes are marked so that each small calibration line on the syringe corresponds to one unit of insulin.

This marking precision helps in administering accurate doses of insulin, which is critical for managing diabetes effectively. Using a U-100 syringe for U-100 insulin ensures that 1 ml of the syringe can hold exactly 100 units, helping healthcare providers and patients in calculating and drawing precise dosages.

It is important not to confuse U-100 insulin syringes with other types of syringes as this could lead to incorrect dosing. Proper usage ensures that patients receive the correct amount of medication as prescribed.

Drawing Insulin into Syringe

Drawing insulin into a syringe correctly is crucial for ensuring the intended dose is administered. Start by washing your hands thoroughly and gathering the necessary supplies: insulin vial, alcohol swab, and syringe.

Clean the rubber stopper of the insulin vial with an alcohol swab. Pull back the syringe plunger to draw air equivalent to the prescribed insulin dose. Insert the needle into the vial and inject the air into the vial; this helps to balance the pressure and makes drawing insulin easier.

Next, with the needle still in the vial, turn the vial upside down and ensure the needle’s tip is submerged in the liquid. Slowly draw back the plunger to the prescribed units, ensuring no air bubbles are present.

If mixing insulins, inject air and draw the rapid-acting insulin (e.g., Humulin R) first, followed by the intermediate-acting insulin (e.g., Humulin N), using one vial at a time. Take care to follow the exact sequence to ensure proper mixing. Check with healthcare provider guidelines for mixing rules specific to insulin types.