Question

Use the following weight-based heparin protocol for question 6. (Round

weight to the nearest tenth as indicated; IV pump is calibrated in whole

mL/hr.)

1. Bolus with heparin at 80 units/kg.

2. Begin intravenous infusion of heparin at 18 units/kg/hr using

25,000 units heparin in 500 mL D5W for 50 units per mL.

3. Adjust intravenous heparin daily based on APTT results.

• APTT less than 35 seconds: Rebolus with 80 units/kg and increase rate

by 4 units/kg/hr.

• APTT 35-45 seconds: Rebolus with 40 units/kg and increase rate by 2

units/kg/hr.

• APTT 46-70 seconds:

No change

.

• APTT 71-90 seconds: Decrease rate by 2 units/kg/hr.

• APTT greater than 90 sec.

Stop heparin

infusion for 1 hour and

decrease rate by 3 units/kg/hr.

6. A client weighs 134.2 lb. Determine the bolus dose of heparin, the

initial infusion rate, and then adjust the hourly infusion rate up or

down based on the APTT results using the above weight-based

heparin protocol. APTT is reported as 31 seconds.

a. __________________________ bolus dosage

b. __________________________ infusion rate (initial)

c. __________________________ mL/hr

Answer 1

Patient weight is 134.2 lb= 60.87 kg ( round= 60 kg)

INITIAL RATE

a.Bolus= 60 x 80= 4800 units

b. IV infusion rate = 60 x 18= 1080 units/ hr (i.e) 21.6ml/hr

APTT=31 SEC

Bolus= 4800 units

c. Iv infusion rate= 22 x 60= 1320 units/ hr (i.e) 26.4 ml/ hr