Heparin Calculations

Order: Heparin 1,800 units/ hr IV Available: 25,000 units heparin in 250 mL D5W What rate in mL per hour will deliver 1,800 units/hr?

18mL/hr

When is it necessary to question an order for heparin?

If the prescribers order is written in anything other than "units" If the dosage amount seems questionable

Heparin administration requirements

Independent verification and Double Checked by another nurse because it is a high alert med

Rebolus of heparin

Is the adjustment of infusion rate (increase, decrease or discontinue)

What are two low molecular weight heparins?

Lovenox and Fragmin

high alert medications

Medications that carry significant risk of causing serious injuries or death to a client if misused ex. Heparin

Order: Infuse 750mL D5W with 30,000 units of heparin at 25 mL/hr. Calculate the dosage in units/hour.

1,000 units/ hour

Order: 40,000 units heparin in 1 L 0.9% NaCl to infuse at 25 mL/hr. Calculate the hourly heparin dosage in units/hr?

1,000 units/hr

Order: Heparin 2500 units in 250 mL D5W to infuse at 11mL/hr Calculate the hourly heparin dosage in units/hr?

1,100 units/hr

The 3 steps of Heparin administration protocol

1. Bolus 2. Continuous Infusion 3. Rebolus

WHat dosage is heparin Lock-Flush Solution available in ?

10 units/mL and 100 units/mL

Order: Heparin 40,000 units in 500 mL D5W to infuse at 30 mL/hr. Calculate the hourly heparin dosage in units/hr?

2,400units/hr

Order: InfUse D5W 1,000 mL with 25,000 units of heparin at 100mL/hour. Determine the dosage in units/hr.

2,500units/hour

Order: HepArin 1,500 units/hr IV. Available 25,000 units of heparin in 500 mL D5W What rate in mL/hr will deliver 1,500 units/hr?

20ml/hr

Order: Infuse 1,000 units/hr of heparin from a solution of 1,000 mL 0.45%NS with 25,000 units of heparin. Calculate the rate in mL/hr

40mL/hr

Order: 1 L of 0.9% NS with 40,000 units heparin over 24 hours Calculate how many mL/hr?

42ml/hr

Order: Heparin 2,000 units/hr IV. Available 25,000 units of heparin in 1,000 mL or 0.9% NS What rate in ml/Hr will deliver 2,000 units/hr?

80mL/hr

Order: Infuse D5 0.9% NS 1,000 mL with 25,000 units of heparin at 35 mL/hr/ Calculate the dosage in units/hour.

875 units/ hR

What syringe is used to admin heparin

A tuberculin (1mL) or prepackaged syringe

Why is close monitoring of clients blood work required when taking heparin?

Because of the bleeding potential associated with anticoagulants

Why is heparin never administered intramuscularly?

Because of the danger of hematomas

Cause of preparation, dispensing and dosing errors

Calculation errors Mix ups with the concentrations of heparin Confusion with the total amount in a vial of heparin and the amount per mL Insufficient monitoring of the client

Dosage of client must be correct to achieve therapeutic effect

Over-dosage = can cause hemmorhage Under-dosage = will not achieve desired effect

When do a majority of heparin medication errors occur?

Preparation, Dispensing and Dosing.

What routes can heparin be administered?

Subcutaneously or intravenously

Heparin is given continuously

This is due to its short half life

What can heparin Lock Flush Solution be used for?

To flush med-locks and specialized IV lines

What can low molecular weight heparins be prescribed for?

To prevent and treat DVTs following abdominal surgery, hip or knee replacement, unstable angina, and cute coronary syndrome

Heparin is always administered through by an electronic infusion device? True or False

True

Initial does of heparin should be based on

clients weight (kg)

When heparin is being administered as a continuous IV infusion, the dosage rate will be ordered in

units/hr, mL/hr or units/kg/hr