The nurse is caring for a client with a DEEP VEIN THROMBOSIS. The client is prescribed a continuous IV heparin of a standard concentration, heparin 25,000 units in 500 mL D5W . After receiving heparin for 6 hours at the PRESCRIBE RATE of 1,300 units/hr. the client's partial thromboplastin time (PTT) is 44 seconds. The nurse must adjust the infusion rate according to the heparin drip protocol, shown in the exhibit. According to protocol , at what RATE in milliliters per hour should the nurse set the IV infusion pump? Record your answer using a whole number. #71914832 (65)
The current dose is 1,300 UNITS/HR. This client's PTT is 44 SECONDS. This is BELOW THE THERAPEUTIC RANGE of 55-70 seconds as slown in the exhibit, indicating that the client requires a higher dose of heparin for adequate anticoagulation. According to the Heparin Anticoagulation Dose Adjustments Protocol (institutions protocols vary) the rate should be increased by 100 units/hr. or to an infusion rate of 1,400 UNITS/HR.
1. Calculate the concentration of the heparin solution.
25,000 units divided by 500 mL = 50 units/mL
2. Calculate the adjusted dose in mL/hr
Desired x quantity
1,400 units x 1 mL = 28 mL/hr.