The following questions refer to your patient who is on IV heparin therapy according to the "Standard Weight-Based Heparin Protocol" noted below. The patient weighs 144 pounds. On admission, the patient's APTT is 30 seconds. You initiate IV heparin therapy at 1130 on 06/06/XX. Record your answers in the spaces below unless provided with the "Standard Weight Based Heparin Protocol Worksheet" by
your instructor.
Standard Weight-Based Heparin Protocol
For all patients on heparin drips:
1. Weight in KILOGRAMS required for order to be processed: ______ kg.
2. Heparin 25,000 units in 250 mL of 1/2 NS. Boluses to be given as 1,000 units/mL.
3. APTT q.6h or 6 hours after rate change; daily after two consecutive therapeutic APTTs.
4. CBC initially and repeat every ____ day(s).
5. Obtain APTT and PT/INR on day one prior to initiation of therapy.
6. Guaiac stool initially, then every __ day(s) until heparin discontinued. Notify if positive.
7. Neuro checks every ____ hours while on heparin. Notify physician of any changes.
8. D/C APTT and CBC once heparin drip is discontinued unless otherwise ordered.
9. Notify physician of any bleeding problems.
10. Bolus with 80 units/kg. Start drip at 18 units/kg/h.
11. If APTT is < 35 secs: Rebolus with 80 units/kg and increase rate by 4 units/kg/h.
12. If APTT is 36-44 secs: Rebolus with 40 units/kg and increase rate by 2 units/kg/h.
13. If APTT is 45-75 secs: Continue current rate.
14. If APTT is 76-90 secs: Decrease rate by 2 units/kg/h.
15. If APTT is > 90 secs: Hold heparin for 1 hour and decrease rate by 3 units/kg/h.
What does the protocol/sample orders indicate for the initial infusion rate for this patient?
?
__________ units/kg/h
?
Calculate the dosage of heparin this patient should receive each hour.
?
__________ units/h
?
What does the protocol/sample orders indicate as the required solution concentration (supply dosage) of heparin to use for the initial infusion?
?
__________ units/mL
?
Calculate the heparin solution volume this patient should receive each hour to provide correct infusion for the patient's weight.
?
__________ mL/h
Fill in the blank(s) with correct word
18 units/kg/h; 1,260 units/h; 100 units/mL; 13 mL/h
You might also like to view...
The president was sent a bill that he did not really like, but he would have been unpopular if he vetoed it, so he did nothing. Which of the following best describes what will happen to the bill?
a. The bill is dead. b. The bill returns to both houses to see if enough votes can be obtained to pass the bill even without the president signing the bill. c. The bill becomes law. d. The bill sits there until the president signs it or vetoes it.
Drugs administered in the epidural space spread by: (Select all that apply.)
a. diffusion through the dura mater. b. transport through blood vessels. c. absorption by fat. d. absorption through muscle.
The nurse is participating in an interprofessional team conference. Which statement indicates that a care provider has a societal attitude that can influence care?
1. "You people always seem to think you know more than me, and I'm the doctor." 2. "The patient agrees to stay in the hospital for treatment despite wanting to go home." 3. "I appreciate having an opportunity to review the patient's physical therapy treatment plan." 4. "Although the prescribed medications are often used for this disease process, the results have not been very good for this patient."
The nurse is caring for a patient with cultural dietary needs. Which of the following questions should the nurse include in a cultural dietary assessment?
a. "What foods are available in the country where you lived?" b. "Which unavailable cultural foods do you prefer to eat?" c. "Which foods do you most commonly eat?" d. "What restaurants do you go to?"