Question

32) What is the initiated infusion rate in ml/hr? Bolus with heparin 80 units/kg. Then initiate heparin drip at 18 units/kghr.Obtain APTT every 6 hours and adjust dosage and rate as follows: If APTT is <35 seconds: Rebolus with 80 units/kg and increase rate by 4 units/kg/hr. If APTT is 36-44 seconds: Rebolus with 40 units/kg and increase rate by 2 units/kg/hr. If APTT is 45-75 seconds: Continue current rate. If APTT is 76-90 seconds: Decrease rate by 2 units/kg/hr. If APTT is> 90 seconds: Hold heparin for one hour and then decrease rate by 3 units/kg/hr. A particular hospital has a weight-based heparin protocol as shown above. A client weighing 198 lbs., has an order of heparin starting at 1600. Heparin concentration available is 25,000 units in 250 mL IV 0.9% NS solution. Pump calibration is set for microdrops. 33) Calculate the heparin bolus dosage. HEPARIN SODIEM Derived from Parcine Idtirel Mucosa 1 mL Multiple Dese Via 34) How many mLs will the nurse administer? Shade the mls calculated on the syringe below.
Please make it clear

Answer 1

32. After giving bolus dosage 80units/ kg. The infusion is initiated at the rate of 18units/kg/hr.

1lb= 0.454kg

198lbs= 0.454*198= 89.8 kgs

Units/hr= 18* 89.8= 1616.4 = 1616units/ hr

Total units (in Infusion bag)/ Total volume(ml)= units per hour/ X ml per hour

25000/250= 1616/ X ml per hour

X ml per hour= 1616/10= 16.16 ( round to 16 as decimals cannot be used in infusion ) = 16ml/ hr.

33. 1 lb= 0.454kg

198lbs= 0.454*198= 89.8 kgs

Heparin bolus = 80units/ kg

For a person weighing 89.8 kgs ,the bolus = 89.8*80= 7184 units

34. Desired dose / dose in hand * volume= ordered dosage

Dose in hand is 5000units per ml

Desired dose is 80 units/ kg which is 7184 units

Ordered dosage= 7184/ 5000*1= 1.4 ml is the bolus dosage to be administered.