You are administering heparin and following the protocol below for a client weighing 189 lbs. The order is to administer an initial heparin bolus IV followed by a titrated IV infusion. Round to the tenths place. HEPARIN PROTOCOL Initial bolus- 50 units/kg Initial rate – 18 units/kg/h Obtain a PTT every 6 hours, and adjust dosage and rate as follows: If PTT is less than 35 secs: Repeat bolus with 80 units/kg and increase the rate by 4 units/kg/h If PTT is 36 to 44 seconds: Repeat bolus with 40 units/kg and increase the rate by 2 units/kg/h If PTT is 45 to 75 seconds: Continue current rate. If PTT is 76 to 90 seconds: If PTT is 76 to 90 seconds: Decrease rate by 2 units/kg/h If PTT is greater than 90 secs: Hold the heparin for 1 hour and decrease rate by 3 units/kg/h Available (for bolus) – heparin 1,000 units/mLAvailable (for infusion) – heparin 25,000 units in 250 mL D5W 6 hours later the PTT results from the lab are- PTT 100 secs for this patient. The client is currently receiving 20units/kg/h After HOLDING the infusion for 1 hour. What rate will the nurse set the pump at for the titrated heparin IV infusion in response to the PTT of 100 secs?
Blog
A client has been diagnosed with condylomata acuminata (geni…
A client has been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?
A client who is being treated for cancer presents with perio…
A client who is being treated for cancer presents with periorbital edema, jugular distension, dyspnea, and cough. The nurse understands these are cardinal signs of which of these following oncologic emergencies?
The priority focused assessments for the client who is recei…
The priority focused assessments for the client who is receiving a heparin infusion include which of the following? SELECT ALL THAT APPLY
A nurse is initiating a blood transfusion of PRBC to a clien…
A nurse is initiating a blood transfusion of PRBC to a client. Initial vital signs are: T 98.6°F, P 66 bpm, RR 16 bpm, B/P 115/72 mmHg, and Pulse Oximetry 98% on room air. After 15 minutes, the nurse rechecks the vital signs and notes the following changes: T 99.8°F, P 72 bpm, RR 18 bpm, B/P 118/76 mmHg, and Pulse Oximetry 98% on room air. Based on this assessment data, the nurse suspects a blood transfusion reaction is most likely occurring. Based on this condition which two interventions in priority order should the nurse take? [action1] [action2] Which two priority parameters/manifestations should the nurse monitor ? [manifestations]
Middle childhood is a period in which some control is transf…
Middle childhood is a period in which some control is transferred from parent to child. This process is gradual and produces:
According to the Erik Erikson, parents who see their childre…
According to the Erik Erikson, parents who see their children’s efforts at making things as “mischief” or “making a mess” will tend to foster a sense of _____ in their children.
I understand that the syllabus is subject to change and assi…
I understand that the syllabus is subject to change and assignments are subject to change. I understand that the syllabus is simply a guide to give me an idea of how the class is planned so I can prepare. Should a change be made I understand that my instructor will notify me in advance in class, in email, or through Canvas. No changes will be made to the grading policy that will negatively impact your grade at any time.
I understand that I will be required to log into Canvas regu…
I understand that I will be required to log into Canvas regularly each week to review learning resources, complete assignments, and check for course announcements and updates as part of my responsibility in this course.
I understand that this class requires me to participate inde…
I understand that this class requires me to participate independently online each week. This course requires access to the internet and computer access each week. Not having a way to connect online each week may be harmful to my grade. Not having access is NOT a valid excuse for not completing work in this course. I understand that any issues that may arise should be reported to my instructor immediately to get help.