Deck 23: Heparin Calculations

Question 1

Directions: Calculate the following hourly dosage of heparin (units/hr).

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A client weighs 70 kg. Heparin infusion: Heparin 25,000 units in 1,000 mL 0.9% sodium chloride.
Order: Bolus with heparin sodium at 90 units/kg, then initiate drip at 20 units/kg/hr.
a. Calculate the heparin bolus dosage: _____
b. Calculate the infusion rate for the IV dosage: _____
c. Determine the rate in mL/hr at which to set the infusion device: _____

Answer 1

a. 90 units/kg * 70 kg = 6,300 units
b. 20 units/kg/hr * 70 kg = 1,400 units/hr
c. 1,000 mL:25,000 units = x mL:1,400 units; x = 56 mL/hr

Question 2

Directions: Calculate the following hourly dosage of heparin (units/hr).

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Order: 45,000 units of heparin in 1,000 mL D5 /2 NS at 25 mL/hr
units/hr = _____

Answer 2

1,125

Question 3

Directions: Calculate the following hourly dosage of heparin (units/hr).

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Order: 40 units/kg/hr heparin IV. The client weighs 116 lb.
How many units should the client receive per hour? _____

Answer 3

116 lb ÷ 2.2 = 52.72 = 52.7 kg
40 units/kg/hr * 52.7 kg = 2,108

Question 4

Directions: Calculate the following hourly dosage of heparin (units/hr).

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Order: 50,000 units of heparin in 1 L D5 0.9% NS to infuse at 40 mL/hr
units/hr = _____

Question 5

Directions: Calculate the following hourly dosage of heparin (units/hr).

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Order: Infuse heparin at 800 units/hr IV from a solution containing 40,000 units in 1,000 mL D5W.
How many milliliters will infuse per hour? _____ mL

Question 6

Directions: Calculate the following hourly dosage of heparin (units/hr).

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Which solution of heparin is more concentrated: 1,000 units per mL or 10,000 units per mL? _____

Question 7

Directions: Calculate the following hourly dosage of heparin (units/hr).

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Order: 40 units/kg/hr heparin IV. The client weighs 50 kg.
How many units should the client receive per hour? _____

Question 8

Order: Heparin 20,000 units in 500 mL D5W to infuse at 12 mL/hr.
Calculate the hourly heparin dosage. ___________________ units/hr

Question 9

Directions: Calculate the following hourly dosage of heparin (units/hr).

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If a U for units was misread as a zero by the nurse for a heparin dose, the consequences to the client receiving the heparin could be ____________________________.

Question 10

Order: Heparin 25,000 units in 500 mL D5W to infuse at 15 mL/hr.
Calculate the hourly heparin dosage. _________________ units/hr

Question 11

Directions: Calculate the following hourly dosage of heparin (units/hr).

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Order: Infuse heparin at 2,000 units/hr IV from a solution containing 20,000 units of heparin in 500 mL D5W.
How many milliliters will infuse per hour? _____ mL

Question 12

Directions: Calculate the following hourly dosage of heparin (units/hr).

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Order: 30,000 units of heparin in 500 mL D5W to infuse at 15 mL/hr
units/hr = _____

Question 13

Directions: Calculate the following hourly dosage of heparin (units/hr).

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Order: 25,000 units heparin IV in 250 mL 0.9% NS to infuse at 20 units/kg/hr. The client weighs 165 lb.
a. Weight in kilograms: _____
b. How many units will the client receive per hour? _____

Question 14

Directions: Calculate the following hourly dosage of heparin (units/hr).
Order: Heparin 5,600 units subcut stat
Available:
a. How many milliliters will you administer? ___________
b. Shade in the dosage on the syringe provided.

Question 15

Directions: Calculate the following hourly dosage of heparin (units/hr).

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Order: 10,000 units of heparin in 500 mL 0.9% NS to infuse at 120 mL/hr
units/hr = _____

Question 16

Directions: Calculate the following hourly dosage of heparin (units/hr).

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A client weighs 220 lb. The hospital protocol for IV heparin drip is 14 units/kg/hr. How many units per hour should the client receive? _____

Question 17

Directions: Calculate the following hourly dosage of heparin (units/hr).

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A client weighs 88 kg. Order: Bolus with heparin at 80 units/kg; initiate drip at 18 units/kg/hr. Heparin infusion 25,000 units in 500 mL 0.9 % sodium chloride.
a. Calculate the heparin bolus dosage: _____
b. Calculate the infusion rate for the IV dosage: _____

Question 18

Directions: Calculate the following hourly dosage of heparin (units/hr).

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Order: 25,000 units of heparin in 250 mL D5W to infuse at 8 mL/hr
units/hr = _____

Question 19

Directions: Calculate the following hourly dosage of heparin (units/hr).

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A client weighs 165 lb. Order: Administer a bolus of heparin sodium IV. The hospital protocol is 80 units/kg. How many units will you administer? _____

Question 20

Directions: Calculate the following hourly dosage of heparin (units/hr).
Order: Heparin 4,600 units subcut 2 hours before surgery
Available:
a. How many milliliters will you administer? _______
b. Shade in the dosage on the syringe provided.

Question 21

Directions: Use the following weight-based heparin protocol for the following problems.
1. Bolus heparin at 80 units/kg
2. Begin intravenous infusion of heparin at 18 units/kg/hr using 25,000 units of heparin in 250 mL of 0.45% NaCl for 100 units per mL.
3. Adjust intravenous heparin daily on the basis of APTT results.
•APTT less than 35 sec. Rebolus with 80 units/kg and increase rate by 4 units/kg/hr
•APTT 35-45 sec. Rebolus with 40 units/kg and increase rate by 2 units/kg/hr
•APTT 46-70 sec. No change
•APTT 71-90 sec. Decrease rate by 2 units/kg/hr
•APTT greater than 90 sec. Stop heparin infusion for 1 hour and decrease rate by 3 units/kg/hr

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A client weighs 81 kg. Determine the bolus dose of heparin, the initial infusion rate, and then adjust the hourly infusion rate up or down on the basis of the APTT results. APTT is reported as 43. The IV pump is calibrated in tenths of a milliliter.

Question 22

Order: Heparin bolus dosage of 40 units/kg IV prior to initiating a continuous infusion.
The client weighs 132 lb.
Available: Heparin 1,000 units per mL
a. Calculate the bolus dosage ______________________
b. Calculate the number of mL that will be needed to administer the dose. ____________

Question 23

A client weighs 110 lb. The hospital protocol is 18 units/kg/hr. How many units per hour will the client receive? ___________________

Question 24

Directions: Use the following weight-based heparin protocol for the following problems.
1. Bolus heparin at 80 units/kg
2. Begin intravenous infusion of heparin at 18 units/kg/hr using 25,000 units of heparin in 250 mL of 0.45% NaCl for 100 units per mL.
3. Adjust intravenous heparin daily on the basis of APTT results.
•APTT less than 35 sec. Rebolus with 80 units/kg and increase rate by 4 units/kg/hr
•APTT 35-45 sec. Rebolus with 40 units/kg and increase rate by 2 units/kg/hr
•APTT 46-70 sec. No change
•APTT 71-90 sec. Decrease rate by 2 units/kg/hr
•APTT greater than 90 sec. Stop heparin infusion for 1 hour and decrease rate by 3 units/kg/hr

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A client weighs 158.4 lb. Determine the bolus dose of heparin, the initial infusion rate, and then adjust the hourly infusion rate based on the APTT results. APTT is reported as 88. The IV pump is calibrated to deliver in tenths of an mL/hr.