This is Sarah with RegisteredNurseRN.com and in this video I'm going to work some heparin drip calculations. And after you watch this video you can access the free quiz at the end of the video that will give you some more practice problems. So let's get started.
The first problem says the MD orders your patient to start an IV heparin drip at 12 units per kilogram per hour. and to administer a loading bolus dose of 60 units per kilogram IV before initiation of the drip. You're supplied with a heparin bag that reads 25,000 units per 250 mLs.
The patient weighs 189 pounds. What is the flow rate? So the first thing what we want to do is we want to take out the most important information to help us solve our problem. And to do that, we have to know what the problem wants us to solve for because heparin drip calculations will ask you to solve for a wide variety of things. This specific problem wants us to figure out the flow rate of this heparin drip.
So we're trying to get to milliliters per hour. And when I work dosage and calculation problems, if you've watched any of my videos, I do dimensional analysis. So that is the way we will be working these and we'll be rounding our answers to the nearest tenth. Always follow what your nursing program wants you to round to or the facility you work at because it varies. Speaker 1 Okay, so we're trying to get milliliters per hour.
Now, some important information that we got from our problem. Our patient's weight. Heparin is weight-based.
You always want to know a patient's weight. They weigh 189 pounds. We need it in kilograms, so we'll be converting that.
We also know that the patient needs to be started at 12 units per kilogram per hour. And we have a bag of heparin on hand. Every bag of heparin varies in size, so always read it and see what it says.
says. It says that in every 250 mLs in that bag, there's 25,000 units of heparin. So let's figure out what we're going to set this pump at for milliliters per hour.
So the first thing what we're going to do is we're going to start out with our weight. Remember, I'm using dimensional analysis. So patient weighs 189 pounds.
Okay, that's our patient. And we need to get to kilograms. So we know from the metric. table, there's 2.2 pounds in one kilogram. So pounds cancels out.
Now we're ready to plug this in. That's what the physician orders the order for the drip to run. So for every kilogram that patient weighs, we're going to be giving them 12 units of heparin per hour.
So 12 units. of heparin per hour. Kilograms cancels out. Remember, we're trying to get milliliters to hour.
We're almost there. Okay, so we have a bag on hand. Bag says there's 25,000 units in that bag of heparin per 250 mLs.
Units cancels out. The more we're left with, we're left with milliliters per hour, which is where we were supposed to go. So we're going to multiply everything.
at the top everything at the bottom and then divide so 189 times 1 times 12 times 250 is what 567 000 and 2.2 times 1 times 1 times 25 000 is 55 000 and when you divide 567 000 by 50 55,000. That's going to give you 10.30909 repeating. And we're going to round to the nearest 10. So our answer is going to be 10.3 milliliters per hour.
That is our answer. Our next problem says your patient has a heparin drip running at 24 milliliters per hour. The heparin bag reads 12,500 units per 250 mL. How many units per hour is the patient receiving? So for this problem, what are we supposed to figure out?
We need to figure out how many units per hour this patient is receiving based on how much is in this bag and what that flow rate is. So we have a bag of heparin hanging and it's telling us that in every 250 mLs, there's 12,500 units of heparin. And we have our pump infusing at 24 mLs per hour. So how many units...
units are really going in per hour. So let's set up a problem using dimensional analysis. So we'll start with the rate that our pump is running.
So it's 24. Milliliters is going in over one hour. Remember, we're trying to get units to hour. And on hand, our bag that's hanging is a 250 ml bag. And it has 12,500. units in it.
Milliliters cancels out, so we're left with units per hour, so we're ready to solve. Multiply everything at the top, everything at the bottom, and then divide. So 24 times 12,000 12,500 equals 300,000 and 1 times 250 is 250. Then 300,000 divided by 250 equals 1,200.
So, 1,200 units per hour is what is infusing on this patient. Our next problem says your patient's recent PTT is 42. According to protocol, you need to increase the heparin drip by 2 units per kilogram per hour and administer 30 units per kilogram IV bolus. You will recheck the PTT in 6 hours.
The patient is currently receiving a heparin drip at 16 units per kilogram per hour from a bag that reads 25,000 units per 250 mL. The patient weighs 163 pounds. How many units will the patient receive as a bolus? And what will... you change the flow rate to?
So for this problem we have a couple things we have to solve for. Number one we have to figure out how many units we're going to give as our bolus. Then we have to figure out what's our new flow rate going to be because their PTT came back where it's not therapeutic.
So we've got to adjust that heparin drip so we can hopefully on the next blood draw get their PTT within range. So looking at that problem what's the important information we need to glean? Okay. Number one, our protocol tells us, because their PTT wasn't therapeutic, that we're going to have to increase the drip by two units per kilogram per hour. It also tells us that because their PTT wasn't therapeutic, that they're going to get a 30 unit bolus per kilogram.
So every kilogram that patient weighs, they're going to get 30 units. Their current pump right now, the pump is currently running at 16 units per kilogram per hour, but we've got to increase that. that. And where are we going to increase that by? Two units.
So let's just go ahead and put that there so we won't forget. So 16 plus two is 18. So where we want to get is 18 units per kilogram per hour. That's the new dosage that they need. Now, what we have, we have on hand a heparin bag that reads for every 250 mLs, there's 25,000 units.
And our patient weighs 100 pounds. 163 pounds. So let's do the easiest part first.
Let's figure out how many units we're going to give them as their bolus. Heparin is weight-based so we need to figure out their weight in kilograms. So 163 pounds is how much our patient weighs.
We know from the metric table that there's 2.2 pounds in one kilogram. So go ahead solve that. 1 times 1 is 163 and 1 times 2.2 is 2.2. So 163 divided by 2.2 equals 74.0909 repeating.
And we're going to round to the nearest tenth. So 74.1 kilograms is how much our patient weighs. So for every kilogram that patient weighs, they need 30 units of heparin for a bolus. So we're just going to multiply that by 30. And 74.1 times 30 equals 2,223 units.
So that is how much of a bolus they're going to get. Now let's figure out our new flow rate. Okay, patient now because we're increasing it from 16 to 18 because they need two extra units.
So we're going to start with our weight. So 163. pounds number one there's 2.2 pounds and one kilogram and our new order is for every kilogram patient weighs the doctor wants them to have 18 units per hour so 18 units hour and pound and kilograms all that had canceled out now on hand we have this bag so 20 25,000 units equals 250 mLs. Units cancels out, and we need to get to milliliters per hour, so we're ready to solve.
So multiply everything at the top and the bottom and divide. So 163 times 1 times 18 times 250 equals 733,500. And 1 times 2.2 times 1 times 25,000 equals 55,000.
Then we'll divide that. 733,500 divided by 55,000 equals 13.336363. Repeating and we'll round to the nearest tenth.
So 13.3 milliliters per hour is our new. new flow rate. Okay, so that wraps up this review over heparin drip calculations.
Thank you so much for watching. Don't forget to take the free quiz and to subscribe to our channel for more videos.