Heparin Math

Question 1

Heparin class

Answer 1

Anticoagulant

Question 2

Heparin MOA

Answer 2

Prevents conversion of fibrinogen to fibrin and prothrombin to thrombin

Question 3

Heparin uses

Answer 3

PE
ACS/MI
Stroke
DVT/VTE
A-fib
DIC
Also to maintain patency of special iv lines

Question 4

Heparin routes

Answer 4

SQ
IV push
IV infusion

Question 5

Heparin SEs

Answer 5

Thrombocytopenia

Hemorrhage

Question 6

Heparin nursing assessment

Answer 6

Signs of bleeding

Labs: PTT, platelets
*therapeutic effect the PTT will be prolonged

Safety: get baselin PTT and plateletes to be able to evaluate later

High alert drug: requires nurse double check of dose, pump setting

Question 7

Heparin dangerous s/s

Answer 7

Blood in stool
GI bleed

Question 8

Info to gather

Answer 8

Weight: 145lb

Available concentration: 25,000 units in 250ml NS

Initial bolus: 60units/kg

Initial rate: 12units/kg/ml

Heparin units/ml: 1000

Question 9

Calculate the bolus in units

Answer 9

Bolus: 60units/kg
Weight: 145lbs (66kg)

60x66=3960 (bolus in units)

Question 10

Calculate bolus dose in ML

Answer 10

Bolus: 60unit/kg
Weight: 145lb(66kg)
Heparin: 1000units/ml

60x66=3980

3960/1000=3.96ml IV push

Question 11

Calculate infusion rate in units

Answer 11

Order: 12unit/kg/hr
66kg

12x66=792units/hr

Question 12

Calculating the infusion rate in ml/hr

Answer 12

Order: 12untis/kg/hr
66kg
Heparin: 25000units/250ml

12x66=792

792/25000x250=7.92

Question 13

Titrating

Answer 13

Increasing or decreasing the drip to achieve a therapeutic PTT

Question 14

PTT results

Answer 14

Less than 33.4 = 50unit bolus and increase by 4units/kg/hr

33.5-44.9 = 25unit bolus and increase by 2unit/kg/hr

45-80 = no change

80.1-100 = reduce by 2unit/kg/hr

100+ = withhold the drip for 1 hour and reduce drip by 3 units/kg/hr