Learn how to mix insulin clear to cloudy. Drawing up and mixing insulin is a skill that nurses will utilize on the job. Insulin is administered to patients who have diabetes. These type of patients depend on insulin so their body can use glucose. Therefore, nurses must be familiar with how to mix insulin.
The goal of this article is to teach you how to mix insulin. Below are a video demonstration and step-by-step instructions on how to do this.
How to Mix Insulin
Purpose of mixing insulin: To prevent having to give the patient two separate injections (hence better for the patient).
Most commonly ordered insulin that are mixed: NPH (intermediate-acting) and Regular insulin (short-acting).
Important Points to Keep in Mind:
- Never mix Insulin Glargine “Lantus” with any other type of insulin.
- Administer the dose within 5 to 15 minutes after drawing up because the regular insulin binds to the NPH and this decreases its action.
- Check the patient’s blood sugar and for signs and symptoms of hypoglycemia to ensure they aren’t hypoglycemic …if patient is hypoglycemic hold the dose and notify md for further orders.
Key Concept for Mixing Insulin: Draw up CLEAR TO CLOUDY
Remember the mnemonic: RN (Regular to Nph)
Why? It prevents contaminating the cloudy insulin with the clear because if contaminated it can affect the action of the cloudy insulin.
Demonstration on Drawing Up Clear to Cloudy Insulin
Steps on How to Mix Insulin
1. Check the doctor’s order and that you have the correct medication:
Doctor’s order says: “10 units of Humulin R and 12 units of Humulin N subcutaneous before breakfast daily”
You’re giving a total of 22 units (10 Regular & 12 NPH)
As the nurse, it is important to know the peak times of the insulin you are giving because this is the most likely time the patient could experience HYPOGLYCEMIA.
- Regular insulin has an onset of 30 minutes, peak 2 hours, and duration of 8 hours
- NPH insulin has an onset of 2 hours, peak 8 hours, and duration of 16 hours
Learn these insulin mnemonics to remember the onset, peak, and duration times.
2. Wash your hands and don gloves!
3. Rotate the “cloudy” insulin to mix the ingredients because if you don’t mix the contents it can alter how much cloudy insulin you are actually drawing up. DON’T SHAKE the vial because this will cause air bubbles!
4. Clean off tops of vials with alcohol prep for 5 to 10 seconds.
5. Remove cap from syringe.
6. Inject 12 units of air into the Humulin-N vial & then remove syringe from vial.
7. Inject 10 units of air into the Humulin-R vial & turn bottle upside down (while syringe still inserted into the bottle) and then withdraw 10 units of clear insulin…REMOVE SYRINGE.
8. Insert syringe into Humulin-N and turn bottle upside down and remove TOTAL UNITS NEEDED by pulling the plunger to 22 units (this will equal removing 12 units of Humulin-N)
9. Recap the needle using the one-hand scoop technique…if not using immediately.
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