Administration
25 units/mL, 50 units/mL, and 100 units/mL
What are the standardized concentrations of heparin infusion prepared by the pharmacy?
The baseline labs that are required prior to initiating heparin infusion.
What is PTT, PT/INR, and CBC ?
The types of drugs should be avoided unless indicated due to the patient's underlying medical condition.
What are coagulation-interfering drugs (e.g., aspirin) and NSAIDs?
Calculate the Loading Dose:
Patient is a 17 y.o. male
Weight: 55 kg
Concentration: 100units/ml
Bonus Question: Rate?
Loadin dose: 75 units/kg
4125 units TRO 10 mins
41.25 ml TRO 10 mins
Rate: 247.5ml/hr
Name one medication that should not be piggybacked with heparin infusion.
What is amiodarone, ciprofloxacin, or gentamycin?
This lab is used to monitor anticoagulation achieved with heparin.
What is PTT or Unfractionated Heparin level?
This should be monitored from lines and tubes.
What is bleeding or discharge?
Calculate Maintenance dose:
Patient is a 6 m.o. Female
Weight 6 kg
Concentration: 100units/ml
Maintenance dose:
Infants <1 year: 28 units/kg/hour
168 units/hr
=1.68 ml/hr.
Must be obtained prior to beginning a heparin infusion and with any rate or dose changes.
What is Independent verification by 2 RNs against the original order?
The amount of time PTT or Unfractionated Heparin level be obtained after the loading dose.
What is 4 hours after the loading dose?
Name one procedure that should be limited to avoid altering skin integrity.
What is intramuscular injections, venipunctures, placement or removal of lines or tubes, rectal medications or temperatures?
Calculate Maintenance dose:
Patient is an 8 y.o. male
Weight 30 kg
Concentration: 100units/ml
Maintenance dose:
Infants > or = 1year: 20 units/kg/hour
600 units/hr
= 6ml/hr
This should be done if the maintenance infusion is delayed more than 30 minutes past the loading dose.
What is contact the prescriber?
The amount of time that PTT or Unfractionated Heparin level be obtained when it is therapeutic.
What is Daily?
The amount of time direct pressure be held if a line must be removed.
What is a minimum of 5 minutes, then re-evaluate for bleeding?
Calculate Maintenance dose:
Patient is a 9 m.o. Female
Weight 10 kg
Concentration: 100 units/ml
Maintenance dose:
Infants <1 year: 28 units/kg/hour
280 units/hr=
= 2.8ml/hr
How long should heparin infusion be held prior to surgery or any invasive procedure?
4 hours
This site should be avoided when collecting blood samples for coagulation studies.
What is collecting from the extremity used for heparin infusion?
The reversal drug for heparin
What is Protamine?
Calculate Maintenance dose:
Patient is a 17 y.o. male
Weight: 55 kg
Concentration: 100 units/ml
Maintenance dose:
Infants > or = 1year: 20 units/kg/hour
1100 units/hr
= 11ml/hr