Chapter 16 Advanced Adult Intravenous Calculations英文学习资料.ppt

? 2006 Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. Advanced AdultIntravenous Calculations Chapter 16 Revised KBurger1108 IV Heparin Anticoagulant – prevention of clot formation High alert medication All heparin orders, dosage, vial, amount and calculations should be checked by another nurse Available in various dosage strengths See figure 16-1 page 406 in Pickar Heparin Flow Rate Set up a ratio-proportion with:- supply dosage strength [units per ml]- ordered infusion dose [units/hr per units/ml] Example: Order: 500 mL D5W with Heparin 25,000 units to infuse @ 850 units / hr25,000units = 850units/hr 500 mL X mL/hr 25,000X = 425,00025,000 25,000 = 17 mL/hr Heparin Flow RatesTry these… 1. The doctor orders heparin to infuse at 800 unit per hour. The pre-mixed intravenous solution available is 250mL D5W with 25000 units heparin added. Calculate the infusion rate for delivery with an infusion pump. 2. The doctor orders heparin to infuse at 750 unit per hour. The pre-mixed intravenous solution available is 500mL D5W with 25000 units heparin added. Calculate the infusion rate for delivery with an infusion pump. Standard Weight-Based Heparin Protocol 1. Weight in kilograms. Required for order to be processed ______kg 2. Heparin 25,000 units in 250mL 1/2NS. Bolus dosage strength 1000units/mL. APTT q6hrs or 6 hrs after rate change; daily for 2 consecutive therapeutic APTTs. CBC initially and repeat every ______day[s] Obtain APTT and PT/INR on day one prior to initiation of therapy Guaiac stool initially then every _____day[s] until heparin d/c Neuro checks every _____hrs while on heparin Discontinue APTT and CBC once heparin is discontinued Notify physician of any bleeding problems Bolus with 80 units/kg. Start drip at 18 units/kg/hr If APTT is less than 35 seconds Rebolus with 80units/kg and increase rate by 4 units/kg/hr If APTT is 36-44 seconds Rebolus with 40