Directions: Use the Following Weight-Based Heparin Protocol for the Following

Directions: Use the following weight-based heparin protocol for the following problems.
1. Bolus heparin at 80 units/kg
2. Begin intravenous infusion of heparin at 18 units/kg/hr using 25,000 units of heparin in 250 mL of 0.45% NaCl for 100 units per mL.
3. Adjust intravenous heparin daily on the basis of APTT results.
•APTT less than 35 sec. Rebolus with 80 units/kg and increase rate by 4 units/kg/hr
•APTT 35-45 sec. Rebolus with 40 units/kg and increase rate by 2 units/kg/hr
•APTT 46-70 sec. No change
•APTT 71-90 sec. Decrease rate by 2 units/kg/hr
•APTT greater than 90 sec. Stop heparin infusion for 1 hour and decrease rate by 3 units/kg/hr
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A client weighs 81 kg. Determine the bolus dose of heparin, the initial infusion rate, and then adjust the hourly infusion rate up or down on the basis of the APTT results. APTT is reported as 43. The IV pump is calibrated in tenths of a milliliter.

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