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)
10 mL/hr
1 mL/hr
100 mL/hr
10.1 mL/hr
The Correct Answer is A
Given:
Ordered dose of Heparin: 18 units/kg/hr
Patient weight: 123 pounds
Concentration of Heparin: 25,000 units/250 mL (100 units/mL)
Step 1: Convert patient weight from pounds to kilograms:
1 pound (lb) = 0.453592 kilograms (kg)
Patient weight in kg = 123 lbs x 0.453592 kg/lb = 55.7923 kg
Step 2: Calculate the total dose of Heparin in units/hr:
Total dose (units/hr) = Ordered dose (units/kg/hr) x Patient weight (kg)
Total dose (units/hr) = 18 units/kg/hr x 55.7923 kg
Total dose (units/hr) = 1004.2614 units/hr
Step 3: Calculate the infusion rate in mL/hr:
Infusion rate (mL/hr) = Total dose (units/hr) / Concentration (units/mL)
Infusion rate (mL/hr) = 1004.2614 units/hr / 100 units/mL
Infusion rate (mL/hr) = 10.042614 mL/hr
Step 4: Round to the nearest tenths:
Infusion rate (mL/hr) ≈ 10.0 mL/hr
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Related Questions
Correct Answer is D
Explanation
A) Transdermal patch:
Transdermal patches are designed for slow, continuous delivery of medication through the skin over a long period of time, typically 24 hours. Although they provide steady medication levels, they do not offer a rapid onset of action. This route is more suitable for long-term control of conditions like angina but is not the fastest for immediate relief.
B) Topical ointment:
Topical ointments are applied to the skin and absorb slowly. While they may have local effects, they are not used for quick systemic effects. In the case of nitroglycerin, topical ointments are generally used for sustained release over several hours and are not intended for immediate relief of chest pain.
C) Suspended release:
Suspended release formulations are designed to release the drug slowly over time. Like transdermal patches, these formulations are meant for long-term management, not for rapid onset. A suspended release formulation of nitroglycerin would not provide the immediate relief that is typically needed in cases of acute angina or chest pain.
D) Sublingual:
The sublingual route provides the most rapid onset of action for nitroglycerin. When nitroglycerin is placed under the tongue, it is absorbed directly into the bloodstream through the mucous membranes of the mouth. This bypasses the digestive system and the liver (first-pass metabolism), allowing the drug to take effect quickly—usually within 1 to 3 minutes—making it ideal for acute relief of chest pain or angina. This route is commonly used for emergencies when rapid relief is needed.
Correct Answer is B
Explanation
Given:
Volume of fluid: 100 mL
Infusion time: 4 hours
Drop factor: 60 gtt/mL
Formula:
Flow rate (gtt/min) = (Volume (mL) / Time (hr)) x Drop factor (gtt/mL) / 60 min/hr
Step 1: Calculate the infusion rate in mL/hr:
Infusion rate (mL/hr) = Volume (mL) / Time (hr)
Infusion rate (mL/hr) = 100 mL / 4 hr
Infusion rate (mL/hr) = 25 mL/hr
Step 2: Calculate the flow rate in gtt/min:
Flow rate (gtt/min) = (Infusion rate (mL/hr) x Drop factor (gtt/mL)) / 60 min/hr
Flow rate (gtt/min) = (25 mL/hr x 60 gtt/mL) / 60 min/hr
Flow rate (gtt/min) = 1500 gtt/hr / 60 min/hr
Flow rate (gtt/min) = 25 gtt/min
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