— 藥理與非經腸給藥 · MEDIUM · SATA —
一位第一型糖尿病病人需施打 NPH 與規則胰島素（Regular insulin）。調配劑量時下列哪些步驟正確？（選所有適合的）
A client with type 1 diabetes is prescribed NPH and regular insulin. Which actions are correct when preparing the dose? (Select all that apply.)
- AInject air into the NPH vial first✓ 正解先將空氣注入 NPH 小瓶
- BWithdraw regular insulin before NPH✓ 正解先抽取規則胰島素再抽取 NPH
- CShake the NPH vial vigorously to ensure uniformity劇烈搖晃 NPH 小瓶以確保均勻
- DCloudy to clear, clear to cloudy由濁轉清，由清轉濁
- EInject air into the regular insulin vial last最後將空氣注入規則胰島素小瓶
— Explanation · 中文詳解 —
混合胰島素之原則為「由清到濁（Clear to Cloudy）」，以避免污染短效胰島素。操作順序：先將空氣注入 NPH（濁），再將空氣注入 Regular（清），抽吸時先抽 Regular（清），再抽 NPH（濁）。NPH 應輕輕滾動而非劇烈搖晃，避免產生氣泡影響劑量。
When mixing NPH and regular insulin, nurses should follow the 'clear to cloudy' principle to prevent contaminating the regular insulin with NPH. This involves injecting air into the NPH vial first without withdrawing medication, then injecting air into the regular insulin vial, and finally drawing up the regular insulin before the NPH.
✦ 台美臨床差異
胰島素混合術是護理技術的基本考題，台美對於「清到濁」的規範一致。