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Zorluk: OrtaPharmacological and Parenteral Therapies

A client with a newly diagnosed deep vein thrombosis is admitted to the medical-surgical unit. The client weighs 85 kg85\text{ kg}. The healthcare provider initiates a weight-based heparin protocol, prescribing a continuous intravenous maintenance infusion at 18 units/kg/hr18\text{ units/kg/hr}. The medication arrives from the pharmacy as a premixed IV bag containing 25,000 units25,000\text{ units} of heparin in 250 mL250\text{ mL} of 0.45%0.45\% sodium chloride. At what rate, in mL/hr\text{mL/hr}, should the continuous infusion pump be set? (Round to the nearest whole number).

Cevap: 15 mL/hr

Cevap

15
To determine the correct IV pump rate, the client's weight (85 kg85\text{ kg}) is multiplied by the continuous maintenance rate (18 units/kg/hr18\text{ units/kg/hr}) to find the total hourly dose (1530 units/hr1530\text{ units/hr}). Next, the concentration of the supplied IV bag is calculated (25,000 units÷250 mL=100 units/mL25,000\text{ units} \div 250\text{ mL} = 100\text{ units/mL}). Dividing the required hourly dose by the concentration yields 15.3 mL/hr15.3\text{ mL/hr}. According to the provided instructions, rounding to the nearest whole number results in 15 mL/hr15\text{ mL/hr}.

Adım Adım Çözüm

1
Calculate the total required units of heparin per hour.
85 kg×18 units/kg/hr=1530 units/hr85\text{ kg} \times 18\text{ units/kg/hr} = 1530\text{ units/hr}.
The maintenance infusion is ordered as a weight-based dose, so the client's total body weight must be multiplied by the prescribed rate.
2
Determine the concentration of the available medication bag.
25,000 units250 mL=100 units/mL\frac{25,000\text{ units}}{250\text{ mL}} = 100\text{ units/mL}.
Finding the amount of units per single mL is necessary to convert the hourly medication dose into an hourly fluid volume.
3
Calculate the infusion pump rate in mL/hr\text{mL/hr}.
1530 units/hr100 units/mL=15.3 mL/hr\frac{1530\text{ units/hr}}{100\text{ units/mL}} = 15.3\text{ mL/hr}.
Dividing the calculated hourly dose by the concentration yields the exact volume of fluid that must be administered each hour.
4
Round the final answer according to the instructions.
15.3 mL/hr15.3\text{ mL/hr} rounds down to 15 mL/hr15\text{ mL/hr}.
The question explicitly requires rounding to the nearest whole number to safely set the IV pump.

Anahtar Kavram

Weight-based intravenous medication calculation and continuous infusion pump rate programming.
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