Question

IV Therapy Case Study This assignment must be completed independently, and returned on or before the due date and time. Failure to return this assignment by the due date will result in zero points awarded Mr. White is a 74-year-old male who is brought to the Emergency Department by a family member after falling at home. He denies hitting his head or losing consciousness. There are no lacerations or open areas noted. He has severe pain in his left leg and rates it at an "8, with a large hematoma forming. After having x-rays, nothing appears to be broken. He denies taking any prescription medications, and states he hasn't seen a physician in years because "they always want to start you on some kind of medication". There is no significant medical histony documented in Mr. White's medical records. His wife passed away about two years ago, and he has been living alone at home since this happened. He has children, but they live in states. They don't visit often, but they do call him every Sunday. After reviewing the patient's case, the physician decides to admit the patient to the medical/surgical unit for generalized weakness and pain control. Admission orders are obtained, and the patient is transferred. The patient weighs 230 lbs other The physician orders Morphine 1 mg IV every hour PRN for pain. What type of IV access device would be placed in this patient (peripheral or central line)? If you choose peripheral, note the appropriate gauge. If you choose central line, note the appropriate type (PICC, non-tunneled, tunneled, or port). [1 point On day three of hospitalization, Mr. White does not appear to be making great strides towards recovery. The pain has improved, but mobility is still limited. He presses his call light telling the nurse that he suddenly has chest pain, shortness of breath, and just doesn't feel right. Upon further care, it is found that he has a positive D-Dimer and CT scan confirms a pulmonary embolism. The physician writes an order to initiate heparin therapy. The patient's aPTT is 39 seconds, and treatment is initiated at 0930 on 1/20/20xX. Complete the heparin worksheet on the next page. The heparin is bolus supply is 5000 units/ml, and the heparin infusion supply is 25,000 units/250 ml D5W. 12 points

Answer 1

* I choose an Extrajugular venous site for the administration of and the gauge is 18, and the rate of infusion is 1-8 microgram/kg/hr

*

Date	Time	APTT	Bolus	Rate Change	New Rate
20/01/2018	1300	33	8320 units/ 18.7ml	Increase infusion by 200units/hr and maintain this rate until next APTT check after 4 hours	8520 units
20/01/2018	1530	45	8520 units	and maintain this rate until next APTT check after 4 hours	No necessary change if the patient clinically stable

Increase the infusion by 200 units/hour and maintain at this rate until next APTT check after 4 hours

*

Date	Time	APTT	Bolus	Rate Change	New rate
20/01/2018	2100	42	8520 units	and maintain this rate until next APTT check after 4 hours	No necessary change if the patient clinically stable

After 6hour APTT rate is 42 seconds if it is increased to 76-90 seconds a decreasing rate by 2units/kg/hr

*Prior to the administration of Levofloxacin we have to assess for the patient renal function and should be administered by slow infusion over 90 minutes every 24 hours.

*For the preparation of a total volume of 150 ml :

30ml (750mg) levofloxacin + 120ml of normal saline for 90minutes.A total of 150ml (30+120 ml)

*The rate of infusion of levofloxacin is 75ml/hr

* Phlebitis, occurs due to the continuous infusion of medication results in the irritation in the lining of the blood vessels

*Stop the infusion, remove the cannula as.soon possible. Assess the site for the signs of any bleeding. Apply a cold compress to the area