[Music] in this video we're going to look at how to properly mix insulins when you're going to give them sub-q now typically we'll mix an intermediate or long-acting insulin like nph with a shorter acting one like regular insulin the big rule to remember is that you always drop clear then cloudy or longer acting before the short acting so first step of course is to calculate the total required volume of medication needed in this case we're going to use an example order of 10 units of nph and 5 units of regular insulin so that's 15 units total so the first thing you want to do is open both vials and clean the top of both vials with an alcohol pad to avoid contamination you can use an individual alcohol pad for each one once you have your vials clean you want to grab your insulin syringe and then you're going to draw back the total amount of air that you need so in this case that's going to be 15 units now insert the needle into the nph vial and inject the dose of air for nph into the vial in this case 10 units so inject the 10 units of air into the nph vial and then you'll still have 5 units of air in needle and you can remove the needle from the nph vial then you're going to take that five units of air and inject it into the regular insulin vial once you've injected that air into the regular insulin vial you can invert it and draw up your five units of regular insulin careful not to overdraw here draw slowly and gently just to five units then remove the needle from the regular and insert it back into the nph vial invert it and draw back exactly the prescribed dose of nph insulin so in this case that's 10 units for a total of 15 units if you accidentally overdraw you'll need to start over because you can't inject it back in and it's already mixed so remove the needle from the nph file and prepare to administer it to the patient if you aren't administering it right away recap it and label the syringe with the drug drugs and doses date time and your initials so to recap you're going to put air in nph air in regular draw up regular then draw up nph or if you want to say clear and cloudy you're going to go air in cloudy air and clear draw up clear draw up cloudy i know it seems silly but it's super important because it helps us prevent cross-contamination of the vials and it makes sure that you get the right doses for your patient now go out and be your best selves today and as always happy nursing thanks for watching another nursing.com lesson click the link below in the description to watch thousands more lessons over on nursing.com also be sure to hit the subscribe and the little bell to make sure you're reminded when new lessons come out and if you want to just keep watching more lessons go ahead and click this video over here to continue learning like we always say here at nursing.com happy nursing