一位第一型糖尿病病人醫囑要求施打 NPH 與短效胰島素。護理師準備在同一針筒中混合施打，應遵循何種步驟？
A client with type 1 diabetes is prescribed NPH insulin and regular insulin. The nurse is preparing to administer both in one syringe. Which steps should the nurse follow?
- ADraw regular insulin into the syringe first, then add NPH insulin✓ 正解先將常規胰島素抽入針筒，再加入NPH胰島素
- BDraw NPH into the syringe first, then add regular insulin先將NPH抽入針筒，再加入常規胰島素
- CInject air into the NPH vial, then inject air into the regular vial先向NPH瓶注入空氣，再向常規瓶注入空氣
- DShake the regular insulin vial before drawing the dose抽取劑量前先搖晃常規胰島素瓶
混合胰島素的黃金原則是「清澈先於混濁」（Clear before Cloudy）。短效胰島素（Regular）為清澈，中效胰島素（NPH）為混濁。為了避免將混濁的 NPH 帶入清澈的短效藥瓶內導致藥物性質改變，務必先抽吸短效胰島素。操作時應先將空氣打入兩瓶藥瓶，再抽吸清澈藥物，最後抽吸混濁藥物。
The golden rule of mixing insulins is 'clear before cloudy.' Regular (short-acting) insulin is clear, while NPH (intermediate-acting) insulin is cloudy. To avoid carrying cloudy NPH into the clear short-acting vial and altering the medication's properties, the regular insulin must be drawn up first. The technique is to first inject air into both vials, then draw up the clear insulin, and finally draw up the cloudy insulin.
兩地護理教育對於胰島素混和順序的標準一致，臨床多強調回抽檢查以防錯抽。