— 藥理與非經腸給藥 · EASY · MCQ —
一位第一型糖尿病病人需施打 NPH 與規則胰島素（Regular insulin）。混和這兩種胰島素時，下列何者正確？
A client with type 1 diabetes is prescribed NPH and regular insulin. Which nursing action is correct when mixing these insulins?
- AInject air into the NPH vial first先向 NPH 藥瓶中注入空氣
- BShake the vials vigorously before drawing抽取前劇烈搖晃藥瓶
- CWithdraw the NPH insulin first先抽取 NPH 胰島素
- DWithdraw the regular insulin first✓ 正解先抽取規則胰島素（Regular insulin）
— Explanation · 中文詳解 —
混合胰島素的黃金法則為「透明在先，混濁在後」（Clear before Cloudy）。規則胰島素為透明的短效型，NPH 為混濁的中效型。若先抽 NPH 可能會污染 Regular 瓶身導致藥效改變。操作順序為：分別注入對應空氣量 -> 抽吸 Regular -> 抽吸 NPH。
The golden rule of mixing insulins is 'clear before cloudy.' Regular insulin is clear and short-acting; NPH is cloudy and intermediate-acting. Drawing up NPH first risks contaminating the regular insulin vial and altering its potency. The procedure is: inject the corresponding amount of air into each vial first, then withdraw the regular insulin, then the NPH.
✦ 台美臨床差異
兩地護理教育皆強調此順序，但現代臨床多推廣預混胰島素筆或分開施打以減少給藥錯誤。