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A patient weighing 63.5 kg was given an initial bolus dose of heparin and began a new heparin drip for the first 6 hours. Using the figure below, what was the total amount of heparin administered in this period? 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) 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 Continuous infusion rate 18 units/kg/h After two (2) consecutive therapeutic APTT levels are obtained, do an APTT daily at 0600 Other (specify: Discontinue all IM medications and other IM injections 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 patient weighing 63.5 kg was given an initial bolus dose of heparin and began a new heparin drip for the first 6 hours. Using the figure below, what was the total amount of heparin administered in this period? 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) 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 Continuous infusion rate 18 units/kg/h After two (2) consecutive therapeutic APTT levels are obtained, do an APTT daily at 0600 Other (specify: Discontinue all IM medications and other IM injections 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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A patient weighing 63.5 kg was given an initial bolus dose of heparin and began a new heparin drip for the first 6 hours. Using the figure below, what was the total amount of heparin administered in this period? 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 units/h) Other (specify: 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
Transcribed Image Text:A patient weighing 63.5 kg was given an initial bolus dose of heparin and began a new heparin drip for the first 6 hours. Using the figure below, what was the total amount of heparin administered in this period? 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 units/h) Other (specify: 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
Expert Solution
Step 1

Anticoagulants

They inhibit the formation of blood clot by obstructing clotting factors. It includes heparin, warfarin and so on.

Heparin

Administration procedure

  • Dosage is based on weight and partial thromboplastin time. 
  • Partial thromboplastin time is not required in subcutaneous administration.
  • Slow administration is recommended.
  • Accurate calculation of drug is essential.
  • Monitor for bleeding, bruising, hypotension, and tachycardia.
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