A patient was prescribed heparin sodium 18 units/kg/h; titrate according to the weight-based heparin protocol. The patient's weight is 123 pounds. Heparin 25,000 units/250 mL (100 units/mL) is available. Calculate the flow rate in mL/h (Round to the nearest tenths)

Ordered dose of 0.9% Sodium Chloride: 20 mL/kg

Child's weight: 55 lbs

Infusion time: 6 hours

Step 1: Convert child's weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Child's weight in kg = 55 lbs x 0.453592 kg/lb = 24.94756 kg

Step 2: Calculate the total volume of 0.9% Sodium Chloride:

Total volume (mL) = Ordered dose (mL/kg) x Child's weight (kg)

Total volume (mL) = 20 mL/kg x 24.94756 kg

Total volume (mL) = 498.9512 mL

Step 3: Calculate the infusion rate in mL/hr:

Infusion rate (mL/hr) = Total volume (mL) / Infusion time (hr)

Infusion rate (mL/hr) = 498.9512 mL / 6 hr

Infusion rate (mL/hr) = 83.15853333 mL/hr

Step 4: Round to the nearest whole number:

Infusion rate (mL/hr) ≈ 83 mL/hr

A) Gamma globulin
Gamma globulin is a blood product used to provide passive immunity by supplying antibodies to prevent or treat certain infections. It is not used for digitalis toxicity, so A is incorrect.

B) Cardizem
Cardizem (diltiazem) is a calcium channel blocker primarily used for controlling heart rate and treating conditions such as atrial fibrillation or angina. It is not used as an antidote for digoxin toxicity, so B is incorrect.

C) Protamine
Protamine is a medication used to reverse the effects of heparin, an anticoagulant. It works by neutralizing the anticoagulant activity of heparin, but it is not used to treat digitalis (digoxin) toxicity, so C is incorrect.

D) Digoxin immune fab
Digoxin immune fab is the specific antidote for digoxin toxicity. It consists of antibodies that bind to digoxin molecules, thereby neutralizing their toxic effects on the heart. This antidote is used when a patient exhibits severe symptoms of digoxin toxicity, such as arrhythmias or life-threatening effects on the heart. Therefore, D is the correct answer.