I also need this I need a how to paper on proper insulin combining and what insulins cannot be mixed with each other?
I've witness nurses incorrectly drawing cloudy before clear, and mixing Regular with lantus. I know you pull up the clear before cloudy as to not contaminate the Regular with long acting, but oters do not. I need to get this info out to the staff, because if I witness two I know there is more doing it. We use lots of agency and I do not know what they are doing. Not to knock agency or anything, this was our own facility nurses I witness doing it incorrectly.
I was taught draw regular and then NPH, but I have to say that hubby diabetic of 45 years always draws nph first. His doctor told him that contaminating nph to reg or reg to nph is still contaminated either way and proper aspiration of the liquid will not result in contamination. There's NO way I'll change his mind!!
okay for your hubby, but that doctor is fruity. It is not okay really. If Regular insulin becomes contaminated and then you need it to bring down a BS of 400 ,and the doctor orders 10units stat and you give it and it doesn't work it is because of this incorrect method your doctor said was ok. Regular is meant to work immediately and rapidly and any form of contamination to the insulin can cause a patient harm. I keep doing it as I was taught. I did report it to all who made that suggestion.
:pYour absolutely right. I'm a type 1 diabetic and do 5 shots a day. I take reg. during the day and lantus at bedtime and I do like you say (your statement on which one to inject air into first & everything). I take my lantus at bedtime and you can't mix it at all. I started out on reg. mixed with nph only at bedtime. You always draw clear before cloudy. I can't believe these nurses are doing it backwards. When I was in LPN school, our instructor must have put that mixing question on at least 200 of our tests. I wasn't diabetic then, but it is definantly memorized now. I called 3 different pharmacists at wal-mart & walgreens(when I was switched from nph to lantus) about why can't lantus be mixed with other insulins and they didn't know why. Does anyone here have a reason why they can't be mixed????????? :rolleyes: p.s. Lantus is the next best thing since the invention of white bread...
I know lantus starts acting 1-2 hrs and it has no peak effect, it last for I believe 24 hrs. I am very curious about Lantus and learning more about it so please if anyone has anything to add?
NEVER mix Lantus Insulin with any other insulin. I always draw up NPH before Regular. That's the way I learned it 30 years ago. I think it's still the same? We have to double check each other each and every time we give insulin.
I am in LPN school and I cannot count the number of times that our Classroom and Clinical instructors, plus nurses at our clinical site and our tests have stressed always draw up clear, then cloudy; regular first, then NPH Also, as Larry 77 said "Air to cloudy then to clear...draw up clear then cloudy
Hopefully you are not using answers on a bulletin board as a basis for your medication adminstration. Do you not have current drug books on your unit? If nurses are not drawing up insulin correctly it is a med error - fill out a QCC or incident report or whatever you call them at you facility. I assume 2 nurses are witnessing insulin since it is a high risk drug.
Hopefully you are not using answers on a bulletin board as a basis for your medication adminstration. Do you not have current drug books on your unit? If nurses are not drawing up insulin correctly it is a med error - fill out a QCC or incident report or whatever you call them at you facility. I assume 2 nurses are witnessing insulin since it is a high risk drug.
First of all I respect you for telling us this, but we do know that or I do. I use lots of books for references. I am just conversing here with thoughts on situations books do not tell you.
I work in a LTC facility 120 patients, low aide ratio, with tons of staffing issues. The nursing staff does not confirm the insulin nor it's correct dose with another nurse. Although, this is idea it is not realistic here nor in some places where only one nurse is on duty either. The patient must recieve the insulin. It is high risk and it is scary to me. I am very careful, but still everyone is human. I did report the errors in a written statement. I did call the attention to the nurses making the error as I previously said.
I know lantus starts acting 1-2 hrs and it has no peak effect, it last for I believe 24 hrs. I am very curious about Lantus and learning more about it so please if anyone has anything to add?
Besides Lantus being amazing what else do you want to know????? Yes it does provide 24 hr. coverage. I feel sooooooo much better on lantus,it does burn sometimes on injection, but almost everytime my husband gives me an injection of my reg, he manages to burn me with that pretty good, IT ISN'T JUST LANTUS.. But lantus has brought my numbers down. They are now lower even if I miss a dose. I can tell by my numbers and the way I feel if I miss my lantus.
Try a web search under The Barbara Davis Center for Childhood Diseases. The produce the Pink Panther book for diabetics by Dr Peter Chase. I was a patient of his many years ago and I still have my original Pink Panther book...it has gone through many changes over the years but last I knew it was online in full text and illistration, and just a great over all diabetes reference. Hope this helps.
:pYour absolutely right. I'm a type 1 diabetic and do 5 shots a day. I take reg. during the day and lantus at bedtime and I do like you say (your statement on which one to inject air into first & everything). I take my lantus at bedtime and you can't mix it at all. I started out on reg. mixed with nph only at bedtime. You always draw clear before cloudy. I can't believe these nurses are doing it backwards. When I was in LPN school, our instructor must have put that mixing question on at least 200 of our tests. I wasn't diabetic then, but it is definantly memorized now. I called 3 different pharmacists at wal-mart & walgreens(when I was switched from nph to lantus) about why can't lantus be mixed with other insulins and they didn't know why. Does anyone here have a reason why they can't be mixed????????? :rolleyes: p.s. Lantus is the next best thing since the invention of white bread...
The chemical make up of lantus when mixed with another insulin changes and when injected produces a rather hard and sometimes painful marble like area in the tissue....it also negates the effect of both insulins, and the only way to soften the area so the body will absorb it is to inject more short acting insulin.....it isn't fun either way.......
Besides Lantus being amazing what else do you want to know????? Yes it does provide 24 hr. coverage. I feel sooooooo much better on lantus,it does burn sometimes on injection, but almost everytime my husband gives me an injection of my reg, he manages to burn me with that pretty good, IT ISN'T JUST LANTUS.. But lantus has brought my numbers down. They are now lower even if I miss a dose. I can tell by my numbers and the way I feel if I miss my lantus.
Maybe it is the alcohol burning in the site. if you use alcohol and do not let it dry or wipe it off after cleaning the site it can travel into the site upon injection and burn. If this isn't the case it must be the insulin and if it is, is it supposed to burn.
:pYour absolutely right. I'm a type 1 diabetic and do 5 shots a day. I take reg. during the day and lantus at bedtime and I do like you say (your statement on which one to inject air into first & everything). I take my lantus at bedtime and you can't mix it at all. I started out on reg. mixed with nph only at bedtime. You always draw clear before cloudy. I can't believe these nurses are doing it backwards. When I was in LPN school, our instructor must have put that mixing question on at least 200 of our tests. I wasn't diabetic then, but it is definantly memorized now. I called 3 different pharmacists at wal-mart & walgreens(when I was switched from nph to lantus) about why can't lantus be mixed with other insulins and they didn't know why. Does anyone here have a reason why they can't be mixed?????????
:rolleyes: 
danursern
122 Posts
okay for your hubby, but that doctor is fruity. It is not okay really. If Regular insulin becomes contaminated and then you need it to bring down a BS of 400 ,and the doctor orders 10units stat and you give it and it doesn't work it is because of this incorrect method your doctor said was ok. Regular is meant to work immediately and rapidly and any form of contamination to the insulin can cause a patient harm. I keep doing it as I was taught. I did report it to all who made that suggestion.
Thanks