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Difficulty: MediumPharmacological and Parenteral Therapies

A client weighing 198198 lb is admitted with a new diagnosis of deep vein thrombosis. The healthcare provider prescribes a continuous intravenous (IV) heparin infusion. The hospital's weight-based protocol orders an initial IV bolus of 8080 units/kg, followed by a continuous infusion at 1818 units/kg/hr. The pharmacy dispenses a premixed IV bag containing 25,00025,000 units of heparin in 250250 mL of 5%5\% Dextrose in Water (D5W).

Based on the protocol, which of the following is the correct continuous infusion rate in mL/hr to program into the IV pump? (Round the final answer to the nearest tenth.)

  1. A
    35.6
  2. 16.2Answer
  3. C
    17.8
  4. D
    72.0

Answer

The correct continuous infusion rate is 16.2 mL/hr.
The correct rate is determined by first converting the client's weight to kilograms (198÷2.2=90198 \div 2.2 = 90 kg). Next, calculate the hourly unit requirement (90×18=1,62090 \times 18 = 1,620 units/hr). Then, determine the concentration of the IV fluid (25,00025,000 units ÷250\div 250 mL = 100100 units/mL). Finally, divide the required hourly units by the concentration to find the rate in mL/hr (1,620÷100=16.21,620 \div 100 = 16.2 mL/hr).

Step-by-Step Solution

1
Convert the client's weight from pounds to kilograms.
198÷2.2=90198 \div 2.2 = 90 kg
Weight-based medication protocols require the client's exact weight in kilograms for safe and accurate dosing.
2
Calculate the prescribed continuous hourly dose of heparin in units.
9090 kg ×18\times 18 units/kg/hr = 1,6201,620 units/hr
The continuous infusion rate is prescribed as 1818 units per kilogram per hour.
3
Determine the concentration of the dispensed heparin IV bag.
25,00025,000 units ÷250\div 250 mL = 100100 units/mL
Finding the concentration of units per mL simplifies the final calculation for the IV infusion pump rate.
4
Calculate the final IV infusion pump rate in mL/hr.
1,6201,620 units/hr ÷100\div 100 units/mL = 16.216.2 mL/hr
The pump must be programmed in mL/hr to deliver the prescribed continuous hourly dose.

Key Concept

Safe calculation of weight-based continuous intravenous medication infusions.
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Topics

Pharmacological and Parenteral Therapies

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