Heparin Math.....HELP

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Heparin Therapy: Math

The health care provider prescribes the following:

  • Administer IV bolus dose of heparin 80 Units per kilogram of body weight.
  • Initiate IV infusion of 500 ml of 5% Dextrose in water with 25,000 Units of heparin at a rate of 20 Units of heparin per kilogram of body weight per hour.

The heparin bolus is available in a 1,000 Unit/ml concentration. Mrs. Adams weighs 187 pounds.

At what rate should the IV pump be set to deliver the prescribed rate of infusion? (Enter numerical value only. If rounding necessary, round to the whole number.)

I have worked this problem several times, and clearly have no idea what I am doing..PLEASE help

Specializes in Complex pedi to LTC/SA & now a manager.

You cannot round weights like that. With critical weight based drugs like heparin, digoxin and some potent antibiotics you can kill or cause permanent harm to a patient. In pediatrics you would easily overdose a small child and risk causing permanent harm or even death.

Don't take the correction personally look at it as a learning experience.

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Well that's good to know but again we we were told to round our weights to the nearest ten like I did in the problem! Just sayin....

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Specializes in ICU.
Ok first lemme just say I was only trying to help so really there is no need to be mean. Second, I was only showing them how I was shown. I'm still in nursing school due to graduate in December so I'm not a new nursing school student just to clear that up. Third this was how I was shown so don't shoot the messenger. I get my math right on my tests all the time! Guess I should have not been so nice to try to help!

This is scary.

Student or 20 year veteran.... We all have something to learn and need to be receptive.

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Specializes in Complex pedi to LTC/SA & now a manager.
Well that's good to know but again we we were told to round our weights to the nearest ten like I did in the problem! Just sayin....

We are telling you that that can kill someone. Rounding to the nearest TENTH is the standard not rounding to the nearest TEN. Perhaps ask your instructors for clarification. I have NEVER heard to round to nearest TEN, especially in dosing calculations. Such a grave difference can be lethal or worse if you round 84kg to 80 (over an 8lb difference!!!) you may under dose a critical weight based antibiotic and cause a drug resistant superinfection. If you round 85kg to 90kg with a drug you will overdose a patient if giving a drug with a narrow therapeutic range.

Rounding 25.25kg to 25.3kg is standard ( rounding to the tenth) Rounding 25.25 kg to 26kg can be lethal. (Rounding to ten)

I strongly suggest you clarify with your instructor about rounding to the ten rather than the practice standard of rounding to the TENTH, especially when it comes to weight.

If you round to the tens place rather than the tenths place on the NCLEX I guarantee your question will be marked incorrectly.

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I will. Thanks!

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Well that's good to know but again we we were told to round our weights to the nearest ten like I did in the problem! Just sayin....

It is nice of you to want to help. The other posters aren't being mean. They just want to show the correct solution. While I can think of situations where rounding a weight is o.k. (i.e. 85.1 kg rounded to 85 kg), rounding up by 5 kgs on a weight based drug is not o.k. I would definitely go back to your instructors and get that issue clarified b/c you have been misinformed and I would hate for you to make a mistake once you are on your own. It does look like you have a good grasp on how to do the math w/ the exception of the rounding issue. Good for you :-)

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Sorry for pretty much repeating the post of "JustBeachyNurse. Did not see it prior to posting my reply.

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I just went back and looked at my notes and they did tell me to round to tens place. That scares the crap outta me!! I will definitely clarify that when I return in august!

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Specializes in Complex pedi to LTC/SA & now a manager.

Are these notes you wrote or notes you were given? Perhaps you misheard ( tens place and tenths place can sound alike) and if you used that method while doing calculations in class it's possible that, coincidentally, it didn't affect your calculations thus far. Especially if it was say a 89.5kg patient you rounded to 90kg the difference could be very small and you still arrived at the correct answers.

Do you have a drug calculation or pharmacology text? What is the method written in there?

I work medically complex/fragile pediatrics and I've seen first hand the permanent damage a drug miscalculation can have on a child's life. A decimal point error changed a responsive, cognitively intact child who could turn his head, look into his parents' eyes and smile (who happened to have CP) into a severely brain damaged, tracheostomy/ventilator dependent, unable to respond 100% dependent on everyone else for everything from breathing to turning. One decimal point error in a drug calculation changed this family's life forever.

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Yeah I wrote the notes but like I said I always get these math problems right so I didn't write them down wrong.

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Well that's good to know but again we we were told to round our weights to the nearest ten like I did in the problem! Just sayin....

That may be but the word that you're getting from experienced nurses is that heparin is a high-risk, weight-dosed medication and rounding up, especially, is unacceptable and in a hospital or a court-room, saying, "that's what I was taught in nursing school" will get you... nowhere you want to be, I promise you.

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Ok!!!!

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