NCLEX-PN

ointments, etc.) and routes of administration (oral, subcutaneous, etc.). The preferred route is oral unless contraindicated. Crushed medications can be mixed with food or liquid for clients with swallowing difficulties, except for time-release capsules, enteric-coated tablets, irritants, and sublingual medications, which should not be crushed. Mixing Two Medications For diabetic clients who require both long-acting (basal) and short-acting (bolus) insulins, it's possible to mix these medications from two vials to reduce the number of subcutaneous injection sites . Here is the step-by-step procedure for safely mixing insulins : 1.​ Preparation : Begin by preparing the top of the vial containing the longer-acting insulin (e.g., NPH insulin) with an alcohol swab. 2.​ Inject Air into the Longer-Acting Insulin Vial : Using an insulin syringe, inject an amount of air that is equal to the ordered dosage of the longer-acting insulin into the vial. Do not withdraw the longer-acting insulin at this point. 3.​ Preparation for the Shorter-Acting Insulin : Next, prepare the top of the vial containing the shorter-acting insulin (e.g., regular insulin) with an alcohol swab. 4.​ Inject Air into the Shorter-Acting Insulin Vial : Using the same insulin syringe, inject an amount of air equal to the ordered dosage of the shorter-acting insulin into this vial. 5.​ Withdraw the Shorter-Acting Insulin : After injecting air into the shorter-acting insulin vial, withdraw the ordered dosage of the shorter-acting insulin into the syringe. 6.​ Withdraw the Longer-Acting Insulin : Finally, withdraw the ordered dosage of the longer-acting insulin into the same insulin syringe. 7.​ Administration : The insulin syringe now contains both the shorter-acting and longer-acting insulins. Administer the combined dose subcutaneously as prescribed. For example, if a client has orders for 10 units of NPH insulin (long-acting) in the morning and an additional 3 units of regular insulin (short-acting) based on a sliding scale, they would follow this procedure to draw up and inject a total of 13 units, which combines both NPH and regular insulins in one syringe. This technique can reduce the number of injections needed, enhancing client comfort and compliance. However, it's crucial to ensure that both insulins are compatible before attempting to mix them. Always follow specific institutional policies and procedures for medication administration. Administering and Documenting Medications Administered Through Common Routes Below, we briefly outline procedures for administering medications through various routes. Please note that the following steps must be completed before administering any medication to a client:

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