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You are here: Home / NCLEX / The Proper Way of Mixing Insulin Injections: NCLEX Study Guide

The Proper Way of Mixing Insulin Injections: NCLEX Study Guide

posted on June 21, 2021

What is Insulin?

Insulin is a hormone produced by the pancreas that helps convert carbohydrates into energy needed by the body. Without proper insulin function, the blood sugar levels may rise to critical levels or drop down too low, which is dangerous for the body.  

Diabetic patients undergo insulin therapies to regulate the sugar levels in the blood and store extra glucose to supply energy to the body. It is vital, especially for patients with Type 2 and gestational diabetes, to restore the insulin that their body fails to produce.

Types of Insulin 

There are different types of insulin: rapid-acting, short-acting, intermediate-acting, long-acting, and premixed. 

  • Long and intermediate-acting insulin takes longer hours to start working. Long-acting usually takes 4 hours to enter the bloodstream, while intermediate takes 1 to 3 but peaks 12-16 hours after. They keep the blood sugar levels within range, even in between meals. Examples of long-acting Insulin are Basaglar, Lantus, Detemir, Degludec, and NPH. 
  • Rapid and short-acting insulin takes a shorter time to take effect. Rapid-acting affects blood sugar levels within 15 minutes right after injection, and short-acting reaches the blood in 30 mins and peaks 2-3 hours after. 
  • Premixed insulin contains a combination of short, long, and intermediate-acting insulin that keeps the blood sugar levels in range during and after meals and even when you’re not eating or in between meals. 

How Insulin is Mixed

Insulin is often mixed to avoid administering two separate injections hence beneficiary for the patient. Using two types of insulin is more effective in keeping the blood glucose within normal range, and has a longer period of effectiveness. When mixing insulin in a single syringe, the doctor would usually prescribe one clear, rapid, and short-acting and a cloudy, long, or intermediate-acting insulin. 

Always remember to draw up clear insulin first rather than the cloudy insulin to prevent contamination of the clear insulin vial with the cloudy one, since it can affect the action of the medication. Mixed insulin should be administered 15-20 minutes after mixing for maximum effectivity. 

Steps in Administering Mixed Insulin:

  • Check the doctor’s order and make sure you have the right medication and materials used for medication administration, such as alcohol, wet and dry cotton balls, and insulin syringe.
  • Wash hands and observe proper donning of gloves.
  • Mix your cloudy insulin vial by rolling it in between your palms or tipping the bottle gently a few times. Never shake the vial when mixing; it could cause bubbles when drawing medication.
  • Wipe the top part of the vials with a cotton swab or cotton balls with alcohol. 
  • Inject air with the same amount of insulin to be drawn to prevent vacuum to both vials.
  • Withdraw the prescribed unit or amount from the “clear” insulin vial and remove the syringe.
  • Insert the same needle into the “cloudy” insulin vial and turn it upside-down and pull the plunger to the total units or amount needed and pull it out.
  • Recap the insulin syringe and prepare for administration.
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Filed Under: Adult Care, Endocrine, Free Study Guides, Fundamentals, NCLEX Tagged With: insulin, insulin injections, mixed insulin, mixing insulin, nclex, nclex review, nclex study guide

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