Insulin – Intermediate Acting (NPH) Nursing Considerations

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Kara Tarr
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Drug Card Insulin-NPH (Intermediate Acting) (Cheatsheet)
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Outline

Generic Name

Insulin NPH

Trade Name

Humulin N, Novolin N

Indication

hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis

Action

stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver,
prevents breakdown of fat and protein

Route Onset Peak Duration
Subcutaneous 1-2 hr 4-12hr 18-24hr

 

Therapeutic Class

antidiabetics, hormones

Pharmacologic Class

pancreatics

Nursing Considerations

• assess for symptoms of hypoglycemia or hyperglycemia
• monitor body weight over time
• may cause decreased inorganic phosphates, potassium, and magnesium
• monitor blood sugars every 6 hours, monitor A1C every 3-6 months

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Transcript

Okay guys, let’s take a look at intermediate-acting insulin or NPH insulin also known as Novolin N or Humulin N. This is an injectable medication, as you can see here. The therapeutic class of intermediate-acting insulin or insulin NPH is an antidiabetic also hormone while the pharmacologic class is pancreatics. Remember that the therapeutic class of a drug is how the drug works in the body in the pharmacologic class is the chemical effect. So intermediate-acting insulin or NPH insulin works by stimulating the uptake of glucose into muscle and fat cells and also inhibits the production of glucose in the liver and prevents the breakdown of fat and protein, which is why intermediate-acting insulin is indicated for hyperglycemia related to type one and two diabetes, and also diabetic ketoacidosis. So with intermediate-acting insulin or insulin NPH, hypoglycemia is most definitely a side effect, which can include things like headache, nausea, drowsiness, sweating, and confusion. And also because insulin is injected, it can cause pain at the injection site.

Some important things to remember with NPH insulin, be sure to assess your patient for symptoms of hypoglycemia and hyperglycemia. Over time, monitor the patient’s body weight as insulin may cause weight increases. It is important to know that intermediate-acting insulin may cause decreased inorganic phosphates, potassium, and magnesium levels. Be sure that the patient knows that blood sugar must be checked every six hours. Although sometimes this can vary depending on the type of insulin, hemoglobin A1C must be checked every three to six months. So NPH insulin is actually known as the cloudy insulin because of the way it looks chemically speaking because it has protamine present. If you have to mix insulins, it is super important to remember that clear insulins such as regular insulin should be always be drawn up first before cloudy. So clear before cloudy. That’s it for intermediate-acting insulin or NPH insulin or Novolin N and Humulin N. Now go out and be your best self today. And as always happy nursing.

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Pharm 1

Concepts Covered:

  • Test Taking Strategies
  • Learning Pharmacology
  • Medication Administration
  • Dosage Calculations
  • Adult
  • Emergency Care of the Cardiac Patient
  • Cardiac Disorders
  • Cardiovascular Disorders
  • Vascular Disorders
  • Hematologic Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of Pancreas
  • Female Reproductive Disorders
  • Immunological Disorders
  • Urinary System
  • Central Nervous System Disorders – Brain
  • Pregnancy Risks
  • Neurological
  • Disorders of the Posterior Pituitary Gland
  • Shock
  • Male Reproductive Disorders
  • Urinary Disorders

Study Plan Lessons

12 Points to Answering Pharmacology Questions
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Basics of Calculations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
IV Infusions (Solutions)
Complex Calculations (Dosage Calculations/Med Math)
Interactive Practice Drip Calculations
Pediatric Dosage Calculations
ACLS (Advanced cardiac life support) Drugs
Amiodarone (Pacerone) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
Anti-Platelet Aggregate
Clopidogrel (Plavix) Nursing Considerations
Coumarins
Warfarin (Coumadin) Nursing Considerations
Thrombin Inhibitors
Enoxaparin (Lovenox) Nursing Considerations
Heparin (Hep-Lock) Nursing Considerations
Thrombolytics
Alteplase (tPA, Activase) Nursing Considerations
Streptokinase (Streptase) Nursing Considerations
Antidiabetic Agents
Glipizide (Glucotrol) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Insulin
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Essential NCLEX Meds by Class
Renin Angiotensin Aldosterone System
Sympatholytics (Alpha & Beta Blockers)
Atenolol (Tenormin) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
ACE (angiotensin-converting enzyme) Inhibitors
Captopril (Capoten) Nursing Considerations
Enalapril (Vasotec) Nursing Considerations
Lisinopril (Prinivil) Nursing Considerations
Angiotensin Receptor Blockers
Losartan (Cozaar) Nursing Considerations
Calcium Channel Blockers
Amlodipine (Norvasc) Nursing Considerations
Diltiazem (Cardizem) Nursing Considerations
Nifedipine (Procardia) Nursing Considerations
Verapamil (Calan) Nursing Considerations
Cardiac Glycosides
Digoxin (Lanoxin) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Furosemide (Lasix) Nursing Considerations
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Spironolactone (Aldactone) Nursing Considerations
Mannitol (Osmitrol) Nursing Considerations
Glucagon (GlucaGen) Nursing Considerations
HMG-CoA Reductase Inhibitors (Statins)
Atorvastatin (Lipitor) Nursing Considerations
Magnesium Sulfate
Nitro Compounds
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
Vasopressin
Epinephrine (EpiPen) Nursing Considerations
Norepinephrine (Levophed) Nursing Considerations
Vasopressin (Pitressin) Nursing Considerations
Anti-Infective – Sulfonamides
Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations
Insulin Drips