Giving NPH AND Regular Insulin?

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  1. This is a discussion on Giving NPH AND Regular Insulin? in General Nursing Discussion, part of General Nursing ... If a patient has scheduled NPH at 8:00am and then ALSO coverge with regular insulin (as per...

    by Nov 2, '06
    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!
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    by KayceeLeeRN Nov 2, '06 4:05 pm
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  3. 12 Comments so far...

  4. Nov 2, '06 by
    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 cniro7PMHNP-BC on Nov 2, '06
  5. Nov 2, '06 by
    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.
    princess007 likes this.
  6. Nov 2, '06 by
    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
    nnurse27 and princess007 like this.
  7. Nov 2, '06 by
    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
  8. Nov 5, '06 by
    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)
    hbjb, princess007, and cursedandblessed like this.
  9. Nov 5, '06 by
    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!!
    princess007 likes this.
  10. May 21, '09 by
    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.
    princess007 likes this.
  11. May 21, '09 by
    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.
    princess007 likes this.
  12. May 21, '09 by
    Cloudy - Clear... Clear - Cloudy