Question

A new diabetic is learning to administer his insulin. He receives $10\mathrm{U}$ of $\mathrm{NPH}$ and $12\mathrm{U}$ of regular insulin each morning. Which of the following statements reflects understanding of the nurse's teaching? A. "When drawing up my insulin, I should draw up the regular insulin first." B. "When drawing up my insulin, I should draw up the NPH insulin first." C. "It doesn't matter which insulin I draw up first." D. "I cannot mix the insulin, so I will need two shots."

Short answer

Answer: The patient should draw up regular insulin first in the syringe, followed by NPH insulin.

Step-by-step solution

Understanding Insulin Types

NPH insulin (Neutral Protamine Hagedorn) is a type of intermediate-acting insulin, while regular insulin is a fast-acting insulin. NPH insulin appears cloudy or milky, and regular insulin is clear. Most of the time, the patient can mix the two types of insulin in a single syringe, but the order of drawing up matters.

Option A: Drawing Regular Insulin First

This statement suggests that the patient should draw up regular insulin first. Since regular insulin is clear, drawing it up first helps prevent the potential contamination of regular insulin vial with NPH insulin. Additionally, this method also ensures accurate dosage of both insulins.

Option B: Drawing NPH insulin First

This statement suggests that the patient should draw up NPH insulin first. This is not the correct method, as drawing up regular insulin first helps prevent contamination and ensures accurate dosing.

Option C: No Preference in Insulin Drawing Order

This statement suggests that it doesn't matter which insulin is drawn up first. This is not correct, as order does matter in order to maintain accurate insulin dosages and prevent contamination between the two types of insulin.

Option D: Unable to Mix Insulin Types

This statement suggests that the patient cannot mix the two types of insulin and will need two separate injections. This is not accurate, as NPH and regular insulin can be mixed in one syringe, given that the proper order of drawing up the insulin is followed (drawing up regular insulin first).

Correct Statement & Conclusion

The correct statement reflecting the understanding of the nurse's teaching about mixing insulin types is Option A. The patient should draw up regular insulin first in the syringe, followed by NPH insulin. This order prevents contamination and maintains accurate dosages of both types of insulin.

Key concepts

Insulin Administration

Administering insulin correctly is a crucial skill for diabetes management. NPH and regular insulin are often used together and can be mixed in one syringe. This approach simplifies the injection process by reducing the total number of injections. However, there is a specific protocol to follow when drawing up these insulins.

• First, always inspect the insulin bottles. Regular insulin should appear clear, while NPH insulin looks cloudy.
• The recommended practice is to draw up regular insulin first, as it avoids contaminating the clear insulin with NPH's cloudy substance.
• Using this order helps in maintaining proper dosage and ensures the insulins do not mix in the vial, which could alter their effectiveness.

Learn to differentiate insulin types and draw them up correctly. This step is key to effective insulin administration.

Nursing Education

Nursing education is crucial in equipping new diabetics with the knowledge and skills they need. It focuses on many aspects, including insulin administration, glucose monitoring, and lifestyle modifications.

• Education should be comprehensive and ongoing, ensuring the patient fully understands their condition and treatment.
• Practical sessions are crucial where patients practice drawing up and administering insulin under supervision.
• The information should be reinforced with written materials and follow-up sessions to address any questions or concerns.

By building confidence and competence in the patient, nursing education plays a significant role in promoting self-care and effective diabetes management.

Diabetes Management

Effective diabetes management involves more than just administering insulin. It is a holistic approach that includes monitoring blood sugar levels and making appropriate lifestyle choices.

• Regular blood sugar monitoring helps in adjusting insulin doses and dietary choices effectively.
• Patients are encouraged to maintain a healthy diet, engage in regular exercise, and monitor their blood sugar levels consistently.


• It's also important to have a regular follow-up with healthcare providers to tailor diabetes management plans as the patient's condition evolves.

Diabetes management is an ongoing process that requires the involvement and commitment of the patient, supported by a knowledgeable healthcare team.