Question

Round the weight to the nearest tenth. A client weighs 210 lb. Heparin IV infusion: heparin sodium 25,000 units in \(1,000 \mathrm{~mL}\) of \(0.9 \% \mathrm{NS}\). Order is to give a bolus with heparin sodium 80 units \(/ \mathrm{kg}\), then initiate drip at 14 units/ \(\mathrm{kg} / \mathrm{hr}\). Calculate the following: a. Heparin bolus dosage b. Infusion rate for the IV (initial) c. At what rate will you set the infusion pump?

Short answer

a. 7624 units, b. 1334.2 units/hr, c. 53 mL/hr.

Step-by-step solution

Convert Weight to Kilograms

The first step is to convert the client's weight from pounds to kilograms because the dosage is ordered in units per kilogram. We know that 1 pound is approximately equal to 0.453592 kilograms. Thus, we calculate:\[\text{Weight in kg} = 210 \times 0.453592 \]This gives us approximately 95.25 kg.

Round Weight to the Nearest Tenth

Based on the calculated value of 95.25 kg, we round to the nearest tenth:\[\text{Rounded weight} = 95.3 \text{ kg}\]

Calculate Heparin Bolus Dosage

Using the rounded weight, calculate the heparin bolus dosage based on the order of 80 units/kg:\[\text{Bolus dosage} = 80 \times 95.3 = 7624 \text{ units}\]

Compute Initial Infusion Dose per Hour

Next, calculate the hourly infusion dose using the rounded weight of 95.3 kg at 14 units/kg/hr:\[\text{Initial infusion dose} = 14 \times 95.3 = 1334.2 \text{ units/hr}\]

Calculate Infusion Rate for IV Setup

Determine the rate of infusion in mL/hr. Since 25,000 units are in 1,000 mL, 1,334.2 units correspond to the following volume:\[\text{Volume (mL)} = \left( \frac{1334.2}{25000} \right) \times 1000 = 53.368 \text{ mL/hr}\]

Round Infusion Pump Rate

Round the infusion rate to the nearest whole number for setting the infusion pump:\[\text{Pump rate} = 53 \text{ mL/hr}\]

Key concepts

Heparin Dosage

Heparin is a common anticoagulant used to prevent blood clots. Calculating the correct dosage is crucial in ensuring patient safety. Heparin doses are often determined based on a patient’s weight in kilograms rather than pounds. Understanding the unit measurement is key. Orders are specified as units per kilogram, which means the patient's weight significantly affects the required dose. For instance, if a prescription requires 80 units per kilogram, you multiply the patient's weight in kilograms by 80. This calculation provides the necessary bolus dosage to be administered. Accurate dosage calculation ensures that the patient receives efficient and safe anticoagulation therapy, minimizing the risk of both bleeding complications and clot formation.

Infusion Rate

Infusion rate refers to how quickly a drug is administered intravenously. It is commonly expressed in milliliters per hour (mL/hr). When calculating the infusion rate, understanding the concentration of the medication per mL of solution is essential. For example, if there's a need to administer 1,334.2 units per hour of heparin, and the preparation contains 25,000 units in 1,000 mL, figuring out how many mL per hour is critical. This involves cross-multiplication. Convert the desired units per hour into the equivalent volume of mL per hour to ensure correct administration. Ultimately, setting the pump correctly optimizes therapeutic effects, offering steady, controlled delivery of medication.

Medication Administration

Medication administration involves precise processes to deliver drugs effectively and safely to patients. Nurses and healthcare professionals must carefully follow protocols and guidelines for dosing and delivery. Calculations need to be double-checked to prevent errors that could affect patient safety. For IV medications like heparin, setting the correct infusion pump rate after calculating the dose is essential. Always double-check patient details and medication orders before any administration. Key steps include confirming patient identity, verifying medication orders, and ensuring a proper understanding of the drug's effects and side effects. This vigilance helps in minimizing errors during the medication administration process.

Weight Conversion

Weight conversion is a critical step when calculating medication dosages, especially when measurements are provided in different units. Typically, medications are prescribed based on weight in kilograms, while weight may initially be recorded in pounds in certain regions like the USA. To convert weight from pounds to kilograms, use the conversion factor: 1 pound equals approximately 0.453592 kilograms. Multiply the weight in pounds by this factor to convert it to kilograms. This process provides an accurate weight value necessary for calculating doses like heparin, which is measured in units per kilogram. Correct weight conversion is crucial in administering the right amount of medication, ensuring both safety and efficacy in treatment.