The Following Questions Refer to Your Patient Who Is on IV

question 14

Essay

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 Weipht Based Heparin Pratocal
For all patients an heparin drips:
1. Weight in kalograms. Reqquired far arder to be proces5ed: $\underline{\quad\quad}$ kg
2. Heparin 25,000 units in 250 mL of $1 / 2$ NS. Boluses to be piven as 1000 unitshmL.
3. APTT q. fh or 6 hours after rate change; q. d. after two consecutive therapeutic APTT's.
4. CBC initally and repeat every $\underline{\quad\quad}$ day(5).
5. Obtain APTT' and PT/NR on day one prior to initiation of therapy.
6. Guaiac stadi initially, then every $\underline{\quad\quad}$ day(s) until heparin diecontinued. Natify if positive.
7. Neura checks every hours while an heparin. Natify physician of any changes.
8. D/C APTT and CBC ance heparin drip is diecontinued unless atherwrise ardered.
9. Natify physician of any bleeding prablems.
10. Bolus with 80 U/kg Start dip at 18 units/ $/ \mathrm { Kg } / \mathrm { h }$ .
11. If APTT' is $< 35$ secs: $\quad$ Rebolus writh 80 units/s and increase rate by 4 units/kg/h
12. If APTT' is 36-44 secs: $\quad$ Rebolus writh 4D units/se and increase rate by 2 units/kg/h
13. If APTT' is 45-75 secs: $\quad$ Continue curtent rate
14. If APTT is 76–90 secs: $\quad$ Decrease rate by 2 unitsh /kg/h
15. If APTT' is > 90 secs: $\quad$ Hold heparin far I hour and decrease rate by 3 units/kg/h
-What is the patient's weight as measured in kilograms? (Round to the nearest 10 kg.)
__________ kg
What does the protocol/sample order indicate for the standard bolus dosage of heparin for this patient?
__________ units/kg

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Definitions:

Preconventional Morality

The first level in Kohlberg's stages of moral development, where behavior is driven by the desire to avoid punishment or gain reward.

Sensorimotor Period

The first stage of Jean Piaget's theory of cognitive development, occurring from birth to approximately two years of age, where an infant's knowledge of the world is limited to their sensory perceptions and motor activities.

Preconventional Level

The first level of Kohlberg's stages of moral development, where an individual's moral reasoning is based primarily on the consequences of actions and on rewards and punishments.

Moral Reasoning

The process of determining what is right or wrong in a given situation, based on ethical principles and moral values.