A patient weighs 158.4lbs. Heparin bolus is 80u/kg, using 25000u of heparin in 2
ID: 138778 • Letter: A
Question
A patient weighs 158.4lbs. Heparin bolus is 80u/kg, using 25000u of heparin in 250mL of 0.45% NaCl for 100 units per mL. Begin intravenous infusion of heparin at 18u/kg/hr. Adjust IV heparin based on APTT results. Calibrate in tenths of a mL
1. Determine the initial bolus dose of heparin. How may mL will be given over 5 min bolus on the pump? (I got 57.6mL)
2. Determine the initial infusion rate in mL/hr? (I got 13mL)
3. One hour later APTT is reported at 88 seconds, decrease rate by 2u/kg/hr. How many mL will be given over 5 min on the pump? (I for 0.4mL)
4. After the adjustment what is the new rate in mL? (I got 13mL)
Not sure if I am doing this right and have more questions like this, please help me before my calculations exam I have to get 100% on to pass!
Explanation / Answer
Patient’s weight = 158.4n lbs = 158 x 1/22 = 71.85 kg
1. Units per 1 ml = 25000 / 250 = 100 units/ ml
Bolus dose = 80u/kg = 80 x 71.85 = 5748 units
ml per bolus = 5748 / 100 = 57.48 = 57.5 ml
2. Staring units per hour = 18 units x 71.8 Kg = 1287 u/hr
25000u of heparin in 250mL of 0.45% NaCl for 100 units per mL.
100 u/ml = 1287/ X ml/hr
X ml / hr = 1287 / 100 = 12.87 = 13 ml/ hour
3.
Decresed rate of infusion (New rate of infusion ) = 18 u/kg/ hr – 2 u/kg/ hr = 16 u/kg/hr
16 units x 71.8 kg = 1148.8 units/ hour
Infusion rate = 25000 units/ 250 ml = 1148.8 units/hr / X ml/ hour
100 units/ ml = 1148.8 u/hr / X ml/hr
X ml/ hr = 1148.8 / 100 = 11.5 ml/ hr = 11.5 ml/ 60 minutes = 0.19ml or 0.2 ml / minute
ml / 5 minutes = 0.2 x 5 minutes = 1.0 ml/ 5 minutes
4. New rate
Staring units per hour = 16 units x 71.8 Kg = 1148.8 units/hr
25000u of heparin in 250mL of 0.45% NaCl for 100 units per mL.
100 u/ml = 1148 u/hr / X ml/hr
X ml / hr = 1148 / 100 = 11. 48= 11.5 ml/ hour
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