Question

Answers 3-9. Explain work.

Heparin Worksheet Your patient has a new order for High Dose Heparin Choose the correct protocol for this patient and calculate initial dose and rate The patient weighs 75 kgs. 1. Does the patient get an initial Bolus dose? Yes No 2. What is the Bolus dose in units ? 10.oout (Hint:'use the protocol) 3. How many mis will you draw up from a 1000 unit/1ml heparin 10ml vial for this bolus dose ? and 4. What if your concentration was 5000 units/ml? How much do you draw up 5. How many units/kg/hr is the initial infusion dose for this patient? 6. What two values are required to set up the infusion pump? 7. By entering these two values what third value will the pump calculate ? 8. When should the 1" Ptt be drawn? 9. Your patient's 6 hr Ptt result comes back as < 52 secs. Please complete the changes per protocol : Draw up the bolus, enter the new dose and calculate new rate. Bolus in Units _and mls_ (concentration=1000 units/ml) CONTINUOUS INFUSION RATE _27 CONTINUOUS INFUSION DOSE 18 wargh RATE VTBI DOSE cong so uniam Condunum Current setting Enter new setting per protocol based on Ptt result

Answer 1

As, per the protocol mentioned the initial dose is 80 units per kg. This patient weighs 75 kgs. So, the initial bolus dose in this patient is 80*75 = 6000 units of heparin.

3) So for the bolus dose of 6000 units of heparin 6 ml should be drawn from 1000 units/ml of heparin 10 ml vial.

1000--1 ml

6000--x

X = 6000 x1 = 1000 = 6ml

4)If the concentration is 5000/ ml, then 1.2 ml should be drawn for bolus dose of 6000 units.

5000--1 ml

6000--x

X = 6000 x 1= 5000 = 1.2ml

5)Initial infusion dose is 18 units/ kg/ hour. So, for this patient 18*75 = 1350 units/kg/hour.

6) The two values required to set the infusion pump are dose(in units) and time ( in hours).

7) By entering these two values, the third value the pump calculate is how much ml per hour to be given.

8) First PTT should be drawn after 6 hours of heparin therapy. If baseline PTT was not drawn within past 24 hours then PTT should be done STAT (immediately).

9)As, the patient's 6 hour PTT is less than 52 .The bolus dose remains the same that is 80 units / kg = 80*75=6000 units.

Infusion dose changes, have to add 4 units/kg/hour to the existing 18 units/kg/hour that means the new infusion dose is 22 units/kg/hour. So, in this patient the infusion dose is 22*75 =1650 units/ hour.

New heparin infusion rate is calculated as follows:

Heparin infusion is available in 25000 units per 500 ml bag of 0.45% NaCl. So,

; X = infusion rate.

25000 = 500 = 1650 = X

  

X = 500 x 1650 - 25000 = 33mlper hour.

So, the heparin infusion rate is 33 ml per hour.