Insulin – Intermediate Acting (NPH) Nursing Considerations

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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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