NCLEX RN Practice Question # 904

NCLEX Examination.

Practice Question # 904.

Administering insulin

• To prevent dosage errors, be certain that there is a match between the insulin concentration noted on the vial and the calibration of units on the insulin syringe; the usual concentration of insulin is U-100 (100 units/mL).
• The Humulin R brand of regular insulin is the only insulin that is formulated in a U-500 strength. U-500 strength insulin is reserved for clients with severe insulin resistance who require large doses of insulin. A special syringe calibrated for use with U-500 insulin is required.

• Prefilled syringes (pens) are commonly used; a new needle needs to be attached before each injection.
• Most insulin syringes have a 27- to 29- gauge needle that is about 0.5-inch long (1.3 cm).
• NPH insulin is an insulin suspension; the appearance is cloudy. All other insulin types are solutions; the appearance of all other insulin products is clear.
• Before use, NPH insulins must be rotated, or rolled, between the palms to ensure that the insulin suspension is mixed well; otherwise, an inaccurate dose will be drawn; vigorously shaking the bottle will cause bubbles to form. It is not necessary to rotate or roll clear insulins before using.
• Inject air into the insulin bottle (a vacuum makes it difficult to draw up the insulin).
• When mixing insulins, draw up the shortest-acting insulin first.
• Short-duration (i.e., regular, lispro, aspart, and glulisine) insulin may be mixed with NPH.