Giving NPH AND Regular Insulin?

  1. If a patient has scheduled NPH at 8:00am and then ALSO coverge with regular insulin (as per FS)...how do I draw up BOTH into a syringe? (because I know I wouldn't give two separate SQ's)

    I just never had to do this at the SAME TIME! Sorry if it's a dumb question...I feel I'm suppose to know this by now, I'm graduating in Demember

    Please HELP!
    •  
  2. 12 Comments

  3. by   Euphrosyne7
    Hi:

    We were taught to always draw up regular first. I believe this is so that the longer acting insulin (NPH) will not contaminate the faster (regular) insulin.
    Last edit by Euphrosyne7 on Nov 2, '06
  4. by   Sunflowerinsc
    Quote from nurse2be1206
    If a patient has scheduled NPH at 8:00am and then ALSO coverge with regular insulin (as per FS)...how do I draw up BOTH into a syringe? (because I know I wouldn't give two separate SQ's)

    I just never had to do this at the SAME TIME! Sorry if it's a dumb question...I feel I'm suppose to know this by now, I'm graduating in Demember

    Please HELP!
    Clear to cloudy. But sometimes you do give 2 sq's. Lantus can not be mixed with any other insulin. If pt is receiving routine Lantus and needs sliding scale cover with another kind ,it's 2 shots.
  5. by   KungFuFtr
    Quote from nurse2be1206
    If a patient has scheduled NPH at 8:00am and then ALSO coverge with regular insulin (as per FS)...how do I draw up BOTH into a syringe? (because I know I wouldn't give two separate SQ's)

    I just never had to do this at the SAME TIME! Sorry if it's a dumb question...I feel I'm suppose to know this by now, I'm graduating in Demember

    Please HELP!
    NPH and Regular are still used nowadays?
    If the dosage is 50u of NPH and 10u of rugular...
    shoot 50units of air into nph vial and withdrawl syringe.
    inject 10 units of air into regular vial and draw back 10u of regular insulin, withdrawl syringe, try not to get bubbles.
    Place syringe back into NPH and draw back to the 60 unit mark. If you go PAST 60 units...never inject mixed insulin back into NPH vial.
    Enjoy
  6. by   vampireslayer
    I always remember the saying "clear before cloudy".

    The trick of course is to remember (as poster said above) to inject the air into the NPH first (but don't draw it out yet). Also, don't forget that you cannot adjust the dose after you draw the NPH, because if you go "back & forth" on the syringe to get it just right, you'll be injecting the Regular into the NPH bottle.

    VS
  7. by   Nursonegreat
    Quote from kungfuftr
    nph and regular are still used nowadays?
    if the dosage is 50u of nph and 10u of rugular...
    shoot 50units of air into nph vial and withdrawl syringe.
    inject 10 units of air into regular vial and draw back 10u of regular insulin, withdrawl syringe, try not to get bubbles.
    place syringe back into nph and draw back to the 60 unit mark. if you go past 60 units...never inject mixed insulin back into nph vial.
    enjoy
    this is exactly it...and i always remember which one to withdraw first by the acronym rn (reg the nph)
  8. by   hollya5334
    Here's a trick they taught me in nursing school. "You can put white milk into your chocolate milk, but you can't put chocolate milk into your white milk" For some reason, that REALLY helped me put it into perspective! Hope this helps!!
  9. by   moleskine44
    This is how i understand this topic.
    1. Put air on insulin N then R.
    2. Turn the R bottle upside down. Check for bubbles.
    3. Withdraw the R then put to N.
    4. Put the N bottle upside down then shake.
    5. Correct amount then withdraw.
  10. by   pagandeva2000
    Think of "RN"...regular first, NPH next. You don't want for any NPH insulin to get into the Regular formula because it it destroys the Regular, making that bottle ineffective.
  11. by   netglow
    Cloudy - Clear... Clear - Cloudy
  12. by   April, RN
    Quote from KungFuFtr
    NPH and Regular are still used nowadays?
    Just curious as to why you asked that? What is used where you work? I work at a large teaching hospital and NPH and regular insulin are used regularly throughout. Do I just work at an outdated facility? Could be entirely possible
  13. by   blondy2061h
    Quote from April, RN
    Just curious as to why you asked that? What is used where you work? I work at a large teaching hospital and NPH and regular insulin are used regularly throughout. Do I just work at an outdated facility? Could be entirely possible
    NPH has fairly erratic action and inconsistent action compared to Lantus. R takes longer to work than newer rapid acting analogs like Humalog, Novolog, and Apidra.

    Unfortunately, yes, they are still used, but there are way better options.
  14. by   April, RN
    On my unit (post op), we do use the other insulins like Lantus and Novolog for patients who come in with known diabetes, but use the regular insulin sliding scale for all our other post op patients. I'm not really sure why we use regular vs Novolog for this though. I'll have to find out tomorrow at work!

close
Giving NPH AND Regular Insulin?