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A blood sample taken from a 247 lb patient 6 hours after heparin therapy is initiated shows an aPTT of 32 seconds. Calculate the nfusion rate, in mL/hr, according to the heparin protocol below. Standard Heparin IV Premixed Solution is 25,000 units in 250 mL (100 units per mL) Initial laboratory tests (draw before starting heparin): aPTT, PT, CBC with platelet count Day 2 and every 3 days thereafter: CBC with platelet count |aPTT six (6) hours after heparin infusion is started Bolus Dose None 80 units/kg (limit 8000 units) -ADULT WEIGHT-BASED HEPARIN PROTOCOL. Other (specify: units) Continuous infusion rate APTT six (6) hours after every change in heparin administration rate or bolus dose of heparin Once a therapeutic aPTT level is reached, do an aPTT six (6) hours later 18 units/kg/h After two (2) consecutive therapeutic APTT levels are obtained, do an aPTT daily at 0600 Discontinue all IM medications and other IM injections Other (specify: units/h) aPTT Value Heparin Dose Adjustments <35 seconds Bolus with 80 units/kg and increase infusion rate by 4 units/kg/h 35 to 45 seconds Bolus with 80 units/kg and increase infusion rate by 2 units/kg/h 46 to 70 seconds No change in infusion rate 71 to 90 seconds Decrease infusion rate by 2 units/kg/h >90 seconds Hold infusion for 1 hour; when restarted, decrease infusion rate by 3 units/kg/h

A blood sample taken from a 247 lb patient 6 hours after heparin therapy is initiated shows an aPTT of 32 seconds. Calculate the nfusion rate, in mL/hr, according to the heparin protocol below. Standard Heparin IV Premixed Solution is 25,000 units in 250 mL (100 units per mL) Initial laboratory tests (draw before starting heparin): aPTT, PT, CBC with platelet count Day 2 and every 3 days thereafter: CBC with platelet count |aPTT six (6) hours after heparin infusion is started Bolus Dose None 80 units/kg (limit 8000 units) -ADULT WEIGHT-BASED HEPARIN PROTOCOL. Other (specify: units) Continuous infusion rate APTT six (6) hours after every change in heparin administration rate or bolus dose of heparin Once a therapeutic aPTT level is reached, do an aPTT six (6) hours later 18 units/kg/h After two (2) consecutive therapeutic APTT levels are obtained, do an aPTT daily at 0600 Discontinue all IM medications and other IM injections Other (specify: units/h) aPTT Value Heparin Dose Adjustments <35 seconds Bolus with 80 units/kg and increase infusion rate by 4 units/kg/h 35 to 45 seconds Bolus with 80 units/kg and increase infusion rate by 2 units/kg/h 46 to 70 seconds No change in infusion rate 71 to 90 seconds Decrease infusion rate by 2 units/kg/h >90 seconds Hold infusion for 1 hour; when restarted, decrease infusion rate by 3 units/kg/h

Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
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**Educational Content on Heparin Protocol** **Scenario** A blood sample taken from a 247 lb patient 6 hours after heparin therapy is initiated shows an aPTT of 32 seconds. Calculate the infusion rate, in mL/hr, according to the heparin protocol below. **Heparin Infusion Protocol Detail** - **Standard Heparin IV Premixed Solution**: 25,000 units in 250 mL (100 units per mL). - **Initial Laboratory Tests**: Conduct tests before starting heparin, including aPTT, PT, CBC with platelet count. Subsequent tests are done on Day 2 and every 3 days thereafter. - **aPTT Testing**: Conduct aPTT six hours after starting the heparin infusion. **Adult Weight-Based Heparin Protocol** 1. **Bolus Dose**: - None - 80 units/kg (limit 8000 units) - Other: ________ units 2. **Continuous Infusion Rate**: - ______________ 3. **Instructions**: - Perform aPTT six hours after each change in heparin administration. - Once a therapeutic aPTT level is reached, do an aPTT six hours later. - After two consecutive therapeutic aPTT levels are achieved, perform aPTT daily at 0600. - Discontinue all IM medications and other IM injections. **aPTT Value and Heparin Dose Adjustments** - **<35 seconds**: Bolus with 80 units/kg and increase infusion rate by 4 units/kg/h. - **35-45 seconds**: Bolus with 80 units/kg and increase infusion rate by 2 units/kg/h. - **46-70 seconds**: No change in infusion rate. - **71-90 seconds**: Decrease infusion rate by 2 units/kg/h. - **>90 seconds**: Hold infusion for 1 hour; when restarted, decrease infusion rate by 3 units/kg/h. **Application to Scenario** For an aPTT of 32 seconds: - Administer a bolus of 80 units/kg. - Increase the infusion rate by 4 units/kg/h according to the table provided. This protocol ensures that heparin therapy is managed according to the patient's aPTT values, thereby optimizing therapeutic efficacy while minimizing risk.
Transcribed Image Text:**Educational Content on Heparin Protocol** **Scenario** A blood sample taken from a 247 lb patient 6 hours after heparin therapy is initiated shows an aPTT of 32 seconds. Calculate the infusion rate, in mL/hr, according to the heparin protocol below. **Heparin Infusion Protocol Detail** - **Standard Heparin IV Premixed Solution**: 25,000 units in 250 mL (100 units per mL). - **Initial Laboratory Tests**: Conduct tests before starting heparin, including aPTT, PT, CBC with platelet count. Subsequent tests are done on Day 2 and every 3 days thereafter. - **aPTT Testing**: Conduct aPTT six hours after starting the heparin infusion. **Adult Weight-Based Heparin Protocol** 1. **Bolus Dose**: - None - 80 units/kg (limit 8000 units) - Other: ________ units 2. **Continuous Infusion Rate**: - ______________ 3. **Instructions**: - Perform aPTT six hours after each change in heparin administration. - Once a therapeutic aPTT level is reached, do an aPTT six hours later. - After two consecutive therapeutic aPTT levels are achieved, perform aPTT daily at 0600. - Discontinue all IM medications and other IM injections. **aPTT Value and Heparin Dose Adjustments** - **<35 seconds**: Bolus with 80 units/kg and increase infusion rate by 4 units/kg/h. - **35-45 seconds**: Bolus with 80 units/kg and increase infusion rate by 2 units/kg/h. - **46-70 seconds**: No change in infusion rate. - **71-90 seconds**: Decrease infusion rate by 2 units/kg/h. - **>90 seconds**: Hold infusion for 1 hour; when restarted, decrease infusion rate by 3 units/kg/h. **Application to Scenario** For an aPTT of 32 seconds: - Administer a bolus of 80 units/kg. - Increase the infusion rate by 4 units/kg/h according to the table provided. This protocol ensures that heparin therapy is managed according to the patient's aPTT values, thereby optimizing therapeutic efficacy while minimizing risk.
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