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
