Question

Pharmacological Therapies

A client has the following insulin ordered for 9PM each day:
20 units regular insulin
12 units NPH insulin
14 units insulin glargine
Which insulins may be combined in one syringe, and what is the step for mixing these insulins?

​The pediatric client has been ordered Cefaclor suspension 20 mg / kg / day in four divided doses. The medication is available in 125 mg / 5 mL. The child weighs 19.8 pounds. What is the total daily dose in mgs? How many mL. will each dose be?

​List three (3) subjective indications of pain.

​A postoperative client is requesting the prescribed oxycodone 5mg by mouth for pain. What assessment data should the nurse collect before administering this medication?

Answer 1

Answer to 1st question:

The regular insulin is a short acting one and NPH insulin is intermediate acting action and another insulin Glargine is long acting one. so in one syringe, only Regular and NPH insulin can be combined and give it to patient.

--The steps for mixing these insulins are

1. first, the NPH insulin bottle should rotate gently to mix the solution well and the top of this NPH insulin vial and regular insulin vial should wipe with alcohol to avoid contamination.

2.Next, draw 12 units of air into the syringe which is equal to the amount of dose in NPH insulin bottle and inject that amount of air into the NPH insulin bottle (cloudy).

3. The 20 units of air also draw into the syringe which is equal amount of dose in regular insulin and inject that amount of air into the regular insulin bottle (clear) .

4. later, invert the regular insulin vial and insert the needle into this and withdraw the 20 units of regular insulin into the syringe without air bubbles and remove needle from that vial.

5. next , insert that needle into the NPH insulin vial and withdraw the 12 units of NPH insulin into the syringe without air bubbles and remove that needle from that vial bottle.

6. Finally, administer the combined insulins in one syringe within 5minutes of its preparation and after administration, dispose the syringe

---The regular and NPH insulins are combined and during mixing always first insert into regular insulin to avoid contamination and also decreases the action of rapid acting insulin with intermediate insulin.

Answer to 2nd question:

Given

orderd dose = 20 mg/ kg / day in 4 divided doses.

Available dose = 125 mg / 5ml

child weight = 19.8 pounds = 8.98 kg

total daily dose in mgs = ordered dose child weight

= 20 mg / kg /day 8.98 kg

= 179.6 mg / day or 180 mg /day

total daily dose in mgs =  179.6 mg / day or 180 mg /day

Total dose is divided in 4 doses per day.

then 180 mg/day 4 doses = 45 mg / dose in one day.

Available dose = 125mg / 5ml = 125 mg per 5mL

total dose = 180 mg per how many mL

each dose has how many mL :

The mL in each dose = ( 180 mg 5mL ) 125 mg

= 900 mg /mL 125 mg

= 7.2 mL

each dose has  7.2 mL