Pediatrics and Heparin IV Calculations -- Please Help!

  1. 0 Hi Everyone:

    I'm currently at the end of my most difficult course in Nursing, all Med-Surg. I had a rotation on the Pediatrics floor and had a 2 week old neonate as my patient. I am required to do calculations for the Heparin that was given but can't seem to find the correct Safe Dose Range reference of numbers :/

    Here is the information I do have:

    Heparin
    250mL bag NaCl 0.225% + 1unit/mL @ 2mL/hour

    All of the ranges I come across refer to 0.5-2 units/mL in a 250mL bag and 28units/kg/dose for maintenance with the running IV at 1-2mL/hour. Is anyone familiar with this type of calculation? Know where to direct me? Or how to explain the circumstances?

    When I calculated the 28 units/kg/dose my instructor said it came to 1.08 mL and stated that I needed to recalculate the medication.

    Thanks in advance!!
  2. Visit  Jeana18 profile page

    About Jeana18

    Jeana18 has '4' year(s) of experience and specializes in 'CNA, Critical Care Tech, Nursing Student'. From 'Milford, CT'; 26 Years Old; Joined Dec '10; Posts: 36; Likes: 6.

    18 Comments so far...

  3. Visit  Laurie52 profile page
    0
    Quote from Jeana18
    Hi Everyone:
    I'm currently at the end of my most difficult course in Nursing, all Med-Surg. I had a rotation on the Pediatrics floor and had a 2 week old neonate as my patient. I am required to do calculations for the Heparin that was given but can't seem to find the correct Safe Dose Range reference of numbers :/

    Here is the information I do have:

    Heparin
    250mL bag NaCl 0.225% + 1unit/mL @ 2mL/hour

    All of the ranges I come across refer to 0.5-2 units/mL in a 250mL bag and 28units/kg/dose for maintenance with the running IV at 1-2mL/hour. Is anyone familiar with this type of calculation? Know where to direct me? Or how to explain the circumstances?

    When I calculated the 28 units/kg/dose my instructor said it came to 1.08 mL and stated that I needed to recalculate the medication.

    Thanks in advance!!
    Need to know how much the baby weighs.
  4. Visit  Halcyonn profile page
    0
    I haven't taken any drug dosage classes, but wouldn't you need to convert kg to mL and then calculate?
  5. Visit  jrenea profile page
    0
    Quote from Jeana18
    Hi Everyone:
    I'm currently at the end of my most difficult course in Nursing, all Med-Surg. I had a rotation on the Pediatrics floor and had a 2 week old neonate as my patient. I am required to do calculations for the Heparin that was given but can't seem to find the correct Safe Dose Range reference of numbers :/

    Here is the information I do have:

    Heparin
    250mL bag NaCl 0.225% + 1unit/mL @ 2mL/hour

    All of the ranges I come across refer to 0.5-2 units/mL in a 250mL bag and 28units/kg/dose for maintenance with the running IV at 1-2mL/hour. Is anyone familiar with this type of calculation? Know where to direct me? Or how to explain the circumstances?

    When I calculated the 28 units/kg/dose my instructor said it came to 1.08 mL and stated that I needed to recalculate the medication.

    Thanks in advance!!
    I hope this helps
    Volume (ml) X (ml/hour)
    Your patient has a DVT is ordered for a heparin infusion to start at 18 units/kg/hour per the practitioner’s order. His weight is 75kg. The heparin infusion comes in a 500ml bag with 25,000 units. Calculate the starting rate of the infusion (ml/hour).
    Step 1: Calculate the starting units per hour. 18 units X 75 kg = 1350 units/hour
    Step 2: Calculate the starting rate of the Infusion (solve for X).
    Heparin Infusion Rate: 25,000 units = 1350 units/hour 500ml X (ml/hour)
    25,000 units (X ml/hr) = 675,000
    X ml/hr = 675,000 25,000
    X = 27 ml/hour
  6. Visit  KelRN215 profile page
    0
    How much does the baby weigh? That's an essential part of this equation that is missing.
  7. Visit  Jeana18 profile page
    0
    Sorry! The baby weighs 3.605 kg.
  8. Visit  Chrono profile page
    0
    so if we go with the numbers you provided, and 4 kg for the infant's weight (since no number provided)

    28 units/kg/hour * 4 kg * 1mL/1 unit = 112 mL/ hr.

    I assume the issue is that you have the incorrect concentration for heparin, it's more likely 100 units/ mL (at least that's all I ever see it as for adults). Based off of the number your clinical instructor came back with that is probably the concentration also.
  9. Visit  Jeana18 profile page
    0
    Sorry. Forgot to put the weight, 3.605 kg. I think the issue is finding a correct safe dose range reference. Any help is appreciated, thanks everyone.
  10. Visit  NotReady4PrimeTime profile page
    1
    Quote from Jeana18
    I am required to do calculations for the Heparin that was given but can't seem to find the correct Safe Dose Range reference of numbers :/

    Here is the information I do have:

    Heparin
    250mL bag NaCl 0.225% + 1unit/mL @ 2mL/hour

    All of the ranges I come across refer to 0.5-2 units/mL in a 250mL bag and 28units/kg/dose for maintenance with the running IV at 1-2mL/hour. Is anyone familiar with this type of calculation? Know where to direct me? Or how to explain the circumstances?

    When I calculated the 28 units/kg/dose my instructor said it came to 1.08 mL and stated that I needed to recalculate the medication.

    Thanks in advance!!
    Okay. The formula you've given for the heparin infusion (250mL bag NaCl 0.225% + 1unit/mL @ 2mL/hour) is the concentration typically used to maintain patency of IV access. At 2 mL/hr this baby is receiving 2 units of heparin per hour or 48 units per day. This is negligible.

    When infusing heparin for other reasons, such as maintaining cardiac shunt or hepatic circulation patency, or for thrombus prophylaxis, the 28 units/kg is an hourly dose run as a continuous infusion. That's the standard dose for those indications. So you would need to calculate the rate this way: (we'll use 4 kg as our example weight)
    4 (kg) x 28 (units/hr) = 112 (units/hr)

    With the concentration of heparin in your bag (1 unit/mL) for anything other htan line patency this baby would need 112 units or 112 mL per hour which is too much fluid for any infant. My unit uses a pharmacy-prepared solution that has a concentration of 100 units/mL, which for this patient would then run at 1.12 mL/hr.

    I think you need more clarification of this that you've provided here.
    Halcyonn likes this.
  11. Visit  Jeana18 profile page
    0
    Quote from Chrono
    so if we go with the numbers you provided, and 4 kg for the infant's weight (since no number provided)

    28 units/kg/hour * 4 kg * 1mL/1 unit = 112 mL/ hr.

    I assume the issue is that you have the incorrect concentration for heparin, it's more likely 100 units/ mL (at least that's all I ever see it as for adults). Based off of the number your clinical instructor came back with that is probably the concentration also.

    Thanks for your help. That makes a lot more sense I'm starting to think that I wrote that down instead of the right number. I will have to double check somehow.
  12. Visit  NotReady4PrimeTime profile page
    0
    Threads merged.
  13. Visit  Jeana18 profile page
    0
    Thank you. I definitely may have written down the wrong number. The 100 units/mL makes much more sense. I will talk to my clinical instructor and clarify with her. Thank you everyone for your wonderful help!! It's greatly appreciated; spent hours pondering what was wrong.
  14. Visit  Chrono profile page
    0
    It could also be the reason stated by janfrn, which I hadn't ever seen before, though I'm still just a student myself.


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