第一型糖尿病患者獲醫囑給予 NPH 及正規胰島素。護理師混合這兩種胰島素時應採取哪些措施？（選所有適合的）
A client with type 1 diabetes is prescribed NPH and regular insulin. Which actions should the nurse take when mixing these insulins? (Select all that apply.)
- AInject air into the NPH vial first✓ 正解先向 NPH 胰島素瓶內注入空氣
- BDraw up the NPH insulin before the regular insulin先抽取 NPH 胰島素
- CInject air into the regular insulin vial last最後向正規胰島素瓶內注入空氣
- DDraw up the regular insulin first✓ 正解先抽取正規胰島素
- EEnsure the NPH is clear before drawing確保 NPH 胰島素澄清後再抽取
混合胰島素（Mixing insulin）必須遵循「先氣後液，先短後長」原則（Clear to Cloudy）。正規胰島素（Regular insulin）為澄清液，NPH 為混濁液。若將 NPH 混入正規胰島素瓶中，會改變正規胰島素的藥效與物理性質。操作順序為：先對兩瓶打入對應劑量的空氣，接著先抽取正規胰島素，最後抽取 NPH，以確保劑量精確且藥物純淨。
When mixing insulins, the rule 'air before fluid, short before long' (clear to cloudy) must be followed. Regular insulin is a clear solution and NPH is cloudy. If NPH contaminates the regular insulin vial, it changes the pharmacologic and physical properties of the regular insulin. The sequence is: first inject the corresponding doses of air into both vials, then draw up regular insulin first, and finally draw up NPH — this ensures accurate dosing and uncontaminated medication.
在美國臨床執業中，護理師需嚴格遵守此混合順序，並在給藥前由另一位護理師進行雙重核對（Double check），以確保胰島素劑量與種類無誤。