Insulin – Intermediate Acting (NPH) Nursing Considerations

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Kara Tarr
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Study Tools For Insulin – Intermediate Acting (NPH) Nursing Considerations

Drug Card Insulin-NPH (Intermediate Acting) (Cheatsheet)
Blank Drug Card Template (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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Test Plan

Concepts Covered:

  • Disorders of the Posterior Pituitary Gland
  • Endocrine
  • Disorders of Pancreas
  • Renal
  • Cardiac Disorders
  • Labor Complications
  • Respiratory Disorders
  • Fetal Development
  • Terminology
  • Musculoskeletal Trauma
  • Pregnancy Risks
  • Medication Administration
  • Vascular Disorders
  • Personality Disorders
  • Newborn Care
  • Substance Abuse Disorders
  • Basics of NCLEX
  • Central Nervous System Disorders – Brain
  • Postpartum Care
  • Cardiovascular Disorders
  • Renal Disorders
  • Disorders of the Adrenal Gland
  • Endocrine and Metabolic Disorders
  • Upper GI Disorders
  • Renal and Urinary Disorders
  • Integumentary Disorders
  • Urinary System
  • Intraoperative Nursing
  • Adulthood Growth and Development
  • Childhood Growth and Development
  • Studying
  • Basics of Human Biology
  • Oncology Disorders
  • Prenatal Concepts
  • Female Reproductive Disorders
  • Neurological Emergencies
  • Male Reproductive Disorders
  • Anxiety Disorders
  • Emergency Care of the Cardiac Patient
  • Gastrointestinal Disorders
  • Integumentary Disorders
  • Liver & Gallbladder Disorders
  • Acute & Chronic Renal Disorders
  • EENT Disorders
  • EENT Disorders
  • Disorders of the Thyroid & Parathyroid Glands
  • Shock
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Immunological Disorders
  • Psychotic Disorders
  • Urinary Disorders
  • Endocrine System
  • Eating Disorders
  • Hematologic Disorders
  • Communication
  • Emergency Care of the Neurological Patient
  • Emergency Care of the Trauma Patient

Study Plan Lessons

03.02 Diabetes Insipidus for CCRN Review
03.04 DKA vs HHNK for CCRN Review
09.05 Chronic Renal Failure for CCRN Review
ACE (angiotensin-converting enzyme) Inhibitors
Adult Vital Signs (VS)
Albuterol (Ventolin) Nursing Considerations
Alpha-fetoprotein (AFP) Lab Values
Amputation
Amputation Concept Map
Angiotensin Receptor Blockers
Antepartum Testing
Antidiabetic Agents
Atenolol (Tenormin) Nursing Considerations
Atypical Antipsychotics
Blood Glucose Monitoring
Blood Urea Nitrogen (BUN) Lab Values
Bloom’s Taxonomy
Brain Tumors
Breastfeeding
Bronchodilators
Cholesterol (Chol) Lab Values
Congenital Heart Defects (CHD)
Congestive Heart Failure Concept Map
Coronavirus (COVID-19) Nursing Care and General Information
Creatinine Clearance Lab Values
Cushing’s Syndrome Case Study (60 min)
Cystic Fibrosis (CF)
Day in the Life of a Med-surg Nurse
Dehydration
Dementia and Alzheimers
Diabetes Insipidus Case Study (60 min)
Diabetes Insipidus Nursing Mnemonic (DDD)
Diabetes Management
Diabetes Mellitus (DM) Module Intro
Diabetes Mellitus & Those Dang Blood Sugars! – Live Tutoring Archive
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus for Progressive Care Certified Nurse (PCCN)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diabetic Emergencies for Certified Emergency Nursing (CEN)
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Encephalopathy (Hypoxic-ischemic, Metabolic, Infectious, Hepatic) for Progressive Care Certified Nurse (PCCN)
Enteral & Parenteral Nutrition (Diet, TPN)
Enuresis
Fluid Shifts (Ascites) (Pleural Effusion)
Fluid Volume Deficit
General Anesthesia
Gestational Diabetes (GDM)
Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive
Glipizide (Glucotrol) Nursing Considerations
Glomerular Filtration Rate (GFR)
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
Growth & Development – Middle Adulthood
Growth & Development -Transitioning to Adult Care
Heart Failure for Certified Emergency Nursing (CEN)
Hemoglobin A1c (HbA1C)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Hypernatremia – Causes Nursing Mnemonic (MODEL)
Insulin
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Key Nutrients in the Prevention of Chronic Disease
Lipase Lab Values
Maternal Risk Factors
Metabolic & Endocrine Module Intro
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic/Endocrine Course Introduction
Metformin (Glucophage) Nursing Considerations
Multiple Myeloma
Myocardial Infarction (MI) Case Study (45 min)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Nursing Care and Pathophysiology for Male Infertility
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Anxiety
Nursing Care Plan (NCP) for Arterial Disorders
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Brain Tumors
Nursing Care Plan (NCP) for Celiac Disease
Nursing Care Plan (NCP) for Cellulitis
Nursing Care Plan (NCP) for Cholecystitis
Nursing Care Plan (NCP) for Chorioamnionitis
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Cleft Lip / Cleft Palate
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Cystic Fibrosis
Nursing Care Plan (NCP) for Dehydration & Fever
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Fluid Volume Deficit
Nursing Care Plan (NCP) for Gestational Diabetes (GDM)
Nursing Care Plan (NCP) for Glaucoma
Nursing Care Plan (NCP) for Hashimoto’s Thyroiditis
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Care Plan (NCP) for Hypoglycemia
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Mastitis
Nursing Care Plan (NCP) for Meconium Aspiration
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Nephrotic Syndrome
Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida
Nursing Care Plan (NCP) for Newborns
Nursing Care Plan (NCP) for Nutrition Imbalance
Nursing Care Plan (NCP) for Omphalocele
Nursing Care Plan (NCP) for Polycystic Ovarian Syndrome (PCOS)
Nursing Care Plan (NCP) for Pressure Ulcer / Decubitus Ulcer (Pressure Injury)
Nursing Care Plan (NCP) for Preterm Labor / Premature Labor
Nursing Care Plan (NCP) for Schizophrenia
Nursing Care Plan (NCP) for Sepsis
Nursing Care Plan (NCP) for Transient Tachypnea of Newborn
Nursing Care Plan (NCP) for Urinary Tract Infection (UTI)
Nursing Care Plan for Amputation
Nursing Care Plan for Coronary Artery Disease (CAD)
Nursing Case Study for Cardiogenic Shock
Nursing Case Study for Diabetic Foot Ulcer
Nursing Case Study for Type 1 Diabetes
Nutrition (Diet) in Disease
Nutrition Assessments
Nutrition-related Diseases
Peripheral Vascular Assessment
Phenobarbital (Luminal) Nursing Considerations
Pituitary Gland
Potassium-K (Hyperkalemia, Hypokalemia)
Propranolol (Inderal) Nursing Considerations
Protein in Urine Lab Values
Red Cell Distribution Width (RDW) Lab Values
Renal Calculi for Certified Emergency Nursing (CEN)
Renal Failure- Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD) for Progressive Care Certified Nurse (PCCN)
SBAR Practice Scenarios
Science of Nutrition
Stroke (CVA) Management in the ER
Stroke Concept Map
Stroke for Certified Emergency Nursing (CEN)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Tenet 3 Why Behind the What
Trauma Surgery – Medical History Nursing Mnemonic (AMPLE)
Urinalysis (UA)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Vasopressin
Vasopressin (Pitressin) Nursing Considerations
What the Heck is Antepartum Testing? – Live Tutoring Archive
Wounds (Infectious, Surgical, Trauma) for Progressive Care Certified Nurse (PCCN)