Podcast
Questions and Answers
Which gauge range is appropriate for an insulin syringe?
Which gauge range is appropriate for an insulin syringe?
- 27-29 gauge (correct)
- 20-22 gauge
- 30-32 gauge
- 22-25 gauge
It is not necessary to rotate insulin injection sites as long as the abdomen is used each time.
It is not necessary to rotate insulin injection sites as long as the abdomen is used each time.
False (B)
What is the primary reason for rotating insulin injection sites?
What is the primary reason for rotating insulin injection sites?
To prevent lipohypertrophy
The fastest and most consistent insulin absorption occurs when insulin is injected into the ______.
The fastest and most consistent insulin absorption occurs when insulin is injected into the ______.
Match the insulin types with their corresponding administration routes.
Match the insulin types with their corresponding administration routes.
Which action is most appropriate when preparing an insulin vial for injection?
Which action is most appropriate when preparing an insulin vial for injection?
It is acceptable to mix long-acting insulin (glargine) with other insulins in the same syringe for convenience.
It is acceptable to mix long-acting insulin (glargine) with other insulins in the same syringe for convenience.
What is the recommended minimum distance to rotate insulin injection sites?
What is the recommended minimum distance to rotate insulin injection sites?
Before injecting insulin, if the skin is visibly dirty, it should be cleaned with ______ and water.
Before injecting insulin, if the skin is visibly dirty, it should be cleaned with ______ and water.
Match the insulin types with their appropriate timing relative to meals:
Match the insulin types with their appropriate timing relative to meals:
Why is a two-nurse check essential when administering insulin?
Why is a two-nurse check essential when administering insulin?
Injecting cold insulin directly from the refrigerator enhances its absorption rate and reduces injection discomfort.
Injecting cold insulin directly from the refrigerator enhances its absorption rate and reduces injection discomfort.
What electrolyte imbalance is most commonly associated with insulin use, particularly in the treatment of diabetic ketoacidosis (DKA)?
What electrolyte imbalance is most commonly associated with insulin use, particularly in the treatment of diabetic ketoacidosis (DKA)?
When administering insulin intravenously, the typical dilution is 100 units of insulin in 100 mL of ______.
When administering insulin intravenously, the typical dilution is 100 units of insulin in 100 mL of ______.
Match each insulin type with its approximate onset of action:
Match each insulin type with its approximate onset of action:
What angle of insertion is recommended when administering insulin subcutaneously using a longer needle?
What angle of insertion is recommended when administering insulin subcutaneously using a longer needle?
Rubbing the injection site vigorously after an insulin injection is recommended to enhance insulin absorption.
Rubbing the injection site vigorously after an insulin injection is recommended to enhance insulin absorption.
How should a nurse correct an air bubble in an insulin syringe before administering the injection?
How should a nurse correct an air bubble in an insulin syringe before administering the injection?
Insulin glargine is typically administered ______ times per day and should not be mixed with other insulins.
Insulin glargine is typically administered ______ times per day and should not be mixed with other insulins.
Match each insulin with their appropriate duration of action:
Match each insulin with their appropriate duration of action:
What is the primary advantage of using an insulin pump?
What is the primary advantage of using an insulin pump?
Prefilled insulin pens are designed to be shared among multiple patients to reduce healthcare costs.
Prefilled insulin pens are designed to be shared among multiple patients to reduce healthcare costs.
List three potential side effects of insulin administration that patients should be aware of.
List three potential side effects of insulin administration that patients should be aware of.
The onset of action for short-acting insulin (insulin regular) is typically ______ minutes.
The onset of action for short-acting insulin (insulin regular) is typically ______ minutes.
Match each ultra long-acting insulin characteristics:
Match each ultra long-acting insulin characteristics:
If a patient is prescribed rapid-acting insulin to be administered with the first bite of their meal, which insulin would be most appropriate?
If a patient is prescribed rapid-acting insulin to be administered with the first bite of their meal, which insulin would be most appropriate?
NPH insulin is a clear solution and does not require mixing before administration.
NPH insulin is a clear solution and does not require mixing before administration.
What is the recommended starting dose for intravenous insulin infusion?
What is the recommended starting dose for intravenous insulin infusion?
To prevent lipodystrophy, it is important to ______ injection sites within the same general area.
To prevent lipodystrophy, it is important to ______ injection sites within the same general area.
Match the following onset, peak, and duration of rapid-acting insulin(insulin lispro)
Match the following onset, peak, and duration of rapid-acting insulin(insulin lispro)
A patient receiving insulin is experiencing tremors, sweating, and confusion. What is the most likely cause?
A patient receiving insulin is experiencing tremors, sweating, and confusion. What is the most likely cause?
Ultra long-acting insulins, such as insulin degludec, are suitable for use in insulin pumps.
Ultra long-acting insulins, such as insulin degludec, are suitable for use in insulin pumps.
Why should insulin syringes be used for insulin administration only?
Why should insulin syringes be used for insulin administration only?
When mixing rapid-acting and intermediate-acting insulins, the ______ insulin should be drawn into the syringe first.
When mixing rapid-acting and intermediate-acting insulins, the ______ insulin should be drawn into the syringe first.
Match the onset, peak, and duration of short-acting insulin:
Match the onset, peak, and duration of short-acting insulin:
A patient with a potassium level of 3.0 mEq/L is prescribed insulin. What nursing action is most important?
A patient with a potassium level of 3.0 mEq/L is prescribed insulin. What nursing action is most important?
Priming an insulin pen involves dialing to 2 units and the dispensing insulin.
Priming an insulin pen involves dialing to 2 units and the dispensing insulin.
Why should you use a darting motion when injecting?
Why should you use a darting motion when injecting?
Ultra long-acting insulins can last up to blank hours.
Ultra long-acting insulins can last up to blank hours.
Match electrolyte imbalance associated with the use of insulin.
Match electrolyte imbalance associated with the use of insulin.
Flashcards
Insulin Administration: Subcutaneous
Insulin Administration: Subcutaneous
Administered subcutaneously using a 27-29 gauge, 3/16-½ inch needle insulin syringe.
Insulin Vial Preparation
Insulin Vial Preparation
Roll the vial gently to ensure particles are dispersed evenly before drawing up insulin.
Ideal Insulin Injection Site
Ideal Insulin Injection Site
The abdomen offers the fastest absorption and most consistent insulin levels.
Insulin Site Rotation
Insulin Site Rotation
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Insulin Pump Administration
Insulin Pump Administration
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Insulin Administration: IV
Insulin Administration: IV
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Insulin Safety
Insulin Safety
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Rotate Injection Sites
Rotate Injection Sites
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Rapid-Acting Insulin (Lispro)
Rapid-Acting Insulin (Lispro)
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Rapid-Acting Insulin: When to Give
Rapid-Acting Insulin: When to Give
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Short-Acting Insulin (Regular)
Short-Acting Insulin (Regular)
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Short-Acting Insulin: Use
Short-Acting Insulin: Use
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Intermediate-Acting Insulin (NPH)
Intermediate-Acting Insulin (NPH)
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NPH Insulin: How to Give
NPH Insulin: How to Give
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Long-Acting Insulin (Glargine)
Long-Acting Insulin (Glargine)
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Long-Acting Insulin: Don't Mix
Long-Acting Insulin: Don't Mix
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Ultra Long-Acting Insulin
Ultra Long-Acting Insulin
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Ultra Long-Acting Insulin: Usage
Ultra Long-Acting Insulin: Usage
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Hypokalemia
Hypokalemia
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Hypophosphatemia
Hypophosphatemia
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Study Notes
Insulin Administration
- Insulin is administered subcutaneously using a 27-29 gauge, 3/16-½ inch needle insulin syringe.
- Gently roll the vial to disperse particles before drawing insulin.
- The abdomen is the site with the fastest absorption and most consistent insulin levels.
- The arm and thigh have slower absorption rates compared to the abdomen.
- Rotate injection sites within the same general area, at least 1 inch apart, to prevent lipohypertrophy.
- Insulin can be administered via reusable or prefilled pens.
- Insulin pens often administer 0.5, 1, or 2 units at a time.
Insulin Pumps
- Insulin pumps deliver insulin subcutaneously.
- Short-acting insulins are usually used in insulin pumps.
- Pumps are more expensive than syringes.
- Microdeposits may affect dose accuracy.
- Continuous and bolus doses can be programmed.
Intravenous Insulin
- Short-acting insulins are administered intravenously.
- Dilute in normal saline at a 1:1 ratio, such as 100 units in 100 mL of normal saline.
- Start IV insulin at 0.1 unit/kg/hour.
Insulin Safety
- Insulin is a high-risk medication.
- Use an insulin syringe that measures units.
- A second licensed nurse should double-check the dosage.
- It's important to understand insulins' onsets, peaks, and durations.
Injection Procedure Best Practices
- Wash your hands thoroughly with soap and water.
- The abdomen absorbs insulin fastest, followed by the thigh, upper arm, and buttocks.
- Rotate injection sites within the same area to prevent lipodystrophy (thickening or thinning of the skin).
- Clean the injection site with soap and water only if visibly dirty.
- Before using, check that the insulin is clear and colorless (except for NPH) and not viscous or cloudy (except NPH).
- If using a vial, clean the rubber top with an alcohol wipe.
- Pull back the plunger to measure the correct dose of air, then inject air into the vial, then draw up the insulin.
- Ensure there are no air bubbles in the syringe before injection.
- If using an insulin pen, follow the manufacturer’s instructions for priming and preparing the pen.
- Never share insulin needles or devices.
- Inject insulin at room temperature.
- Pinch the skin gently around the injection site.
- Insert the needle at a 45-degree angle for long needles and a 90-degree angle for short needles, using a darting motion.
- Leave the syringe in place for a few seconds after injecting.
- Withdraw the needle quickly and gently and do not rub the injection site.
- Dispose of the syringe properly in a sharps container.
- Monitor blood glucose levels after injection.
- Be aware of potential side effects such as hypoglycemia, injection site reactions, and allergic reactions.
Rapid Acting Insulin (Lispro)
- Onset: 15-30 minutes
- Peak: 0.5-3 hours
- Duration: 3-5 hours
- Administer subcutaneously 5-15 minutes before meals or with the first bite of food. Lispro and aspart may be dosed after meals if needed. Also used for external insulin pumps and sliding scales.
Short Acting Insulin (Regular)
- Onset: 30-60 minutes
- Peak: 2-4 hours
- Duration: 4-12 hours
- Administer subcutaneously 30 minutes before meals. Commonly given IV. Also used for external insulin pumps and sliding scales.
Intermediate Acting Insulin (NPH)
- Onset: 1-2 hours
- Peak: 4-12 hours
- Duration: 14-24 hours
- May mix in syringe with short duration insulins: rapid-acting and slower-acting. It is the only cloudy insulin. Usually given subcutaneously with regular insulin before breakfast and dinner (2x/day).
Long Acting Insulin (Glargine)
- Onset: 2-4 hours
- Peak: No peak, levels are steady
- Duration: Up to 24 hours
- Administer subcutaneously 1x day (usually at bedtime). May be given 2x a day with regular insulin adjusted for each meal. Do NOT mix in same syringe with other insulins
Ultra Long Acting Insulin (Degludec)
- Onset: 1-2 hours
- Peak: No peak, levels are steady
- Duration: Up to 42 hours
- Administer subcutaneously via injection or pen 1x day (no pumps). Used in basal-bolus regimens with a short or rapid-acting insulin. Do NOT mix with other insulins.
Electrolyte Imbalances
- Hypokalemia (low potassium) can occur because insulin promotes potassium entry into skeletal muscle and liver cells.
- Hypophosphatemia (low phosphorus) can occur because insulin shifts phosphorus into cells, mainly in individuals with diabetes or undergoing treatment for DKA.
- Additional imbalances include hypomagnesemia (low magnesium), hyponatremia (low sodium), hypochloremia (low serum chloride), and hypocalcemia (low calcium).
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