Question

Below is your Heparin Protocol Table. Use the information in the table to answer the following questions. Supply is heparin 25,000 units/ 500 ml Patient weight: 176 lb Current Infusion Rate: 15 ml/hr Question: If your patient has a PTT of 198 seconds, what will your new infusion rate be? If no change put the current infusion rate. <45 Seconds 61-80 PTT 46-60 101 81-100 Bolus or loading dose Bolus with 30 units/kg Bolus with 30 units/kg No bolus No bolus No bolus increase rate by increase rate by increase rate by Decrease rate by 1 unit/kg/hour Rate adjustment No change 3 units/kg/hour 2 units/kg/hour 1 units/kg/hour PTT in 6 hours Next lab PTT in 6 hours PTT in the am PTT in 6 hours PTT in 6 hours O 13.4 ml/hr 15 ml/hr O 1.6 ml/hr no choices are correct

Answer 1

The question numbers are not given in the questions. So Iam putting 1,2,3 according to the question order given:

1. Heparin available = 25000units/500ml

Each ml contains, 50 units per ml

Patient weight = 176 lb = 80kg

Infusion rate = 15 ml/hour

Infusion rate = 15 × 50 units/hour =   750 units/hour

When the PTT is above 101 sec, the rate of infusion has to be decreased by 1unit/kg/hour

750-80= 670 units /hour

Heparin infusion of 15ml/hour = 750 units /hour of Heparin

Therefore 670 units/hour = 15 × 670/750 = 13.4 ml/hour

2. Order = Bretylium 3mg/min

Available medicine = 500mg in 200 ml

Rate of medicine per hour is 3 × 60 = 180 mg/hour

Amount to be administered =

dose prescribed amount in hand dose in hand

                                               =     =90ml

180x250 500

90 ml/hour is the pump rate

3. Supply of insulin is 250 units/ 500ml

Each ml contains 0.5 units of Insulin

2 ml of fluid contains 1 unit of insulin

Prescribed rate = 20 units per hour = 20 × 2 = 40 ml /hour

4. Dopamine ordered dose = 20 mcg/kg/min

Weight of the patient = 132 lbs = 60 Kg

The dose for the patient = 20×60 mcg /min = 20 ×60 ×60 mcg /hour

                                          = 72000mcg/ hour =72 mg/hour

The supply of Dopamine available = 250 mg in 100 ml D5W

The amount to be administered per hour =     = 28.8 ml

72x100 250

The rate of the infusion pump should be 28.8 ml/hour