# The doctor orders Heparin for the patient, a bolus of 60 units/kg to

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Your patient weighs 96 lb. The doctor orders Heparin for the patient, a bolus of 60 units/kg to be pushed over 5 minutes and an infusion to run 14 units/kg/hr. You have Heparin Sodium with a concentration of 800 units/mL available for the bolus. For the infusion you have bags with 25,000 units of Heparin in 1000 mL D5W.

In addition, every six hours the patient’s blood will be tested for clotting time, and the aPTT result will be determined. Here is the heparin protocol to be used.

 aPTT Result Bolus Dose Hold time (min) for Infusion Change to Infusion Rate Less than 55 15 units/kg No hold Increase 4 units/kg/hr 55-69 10 units/kg No hold Increase 2 units/kg/hr 70-79 5 units/kg No hold Increase 1 unit/kg/hr 80-100 No bolus given No hold No Change 101-110 No bolus given No hold Decrease 1 unit/kg/hr 111-120 No bolus given 30 Decrease 2 unit/kg/hr 121-140 No bolus given 60 Decrease 3 units/kg/hr More than 140 No bolus given 90 Decrease 5 units/g/hr

Question: At what rate to set the initial IV infusion.

available: 25,000 units in 1000 mL D5W

units per mL = 25000 units/1000 mL = 25 units/mL

14 units/kg/hr: for 43.6 kg = 610 units/hr.

610 units/hr(25 units/mL/) = 24.4 mL/hr.