The Following Questions Refer to Your Patient Who Is on IV

question 3

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
-According to the protocol/sample order, how often should the patient's APPT be checked?
q.__________h
At 1730, the patient's APPT is 38 seconds. Rebolus with heparin $\quad$ $\underline{\quad\quad}$$\text { units }$$\quad$ $\quad$ ( $\underline{\quad\quad}$$\mathrm{mL}$ )
How much should you change the infusion rate?
__________ increase or __________ decrease heparin __________ units/h and __________ ml/h.
The new infusion rate will be heparin __________ mL/h.

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