Insulin calc help

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hi everyone, it's nice to be here. please can someone help me with this drug calculation, will like to know what fomular to get the answer too, thanks in advance.

:confused: a patient who weighs 125 lbs. and has iv heparin ordered per the following weight based heparin protocol:

heparin iv infusion: heparin 25,000 u in 250 ml of ½ ns

iv boluses: use heparin 1000 u / ml

bolus with heparin 80 u/kg. then initiate heparin drip at 18 u/kg/h. obtain aptt every 6 hours and adjust dosage and rate as follows:

if aptt is

if aptt is 36-44 seconds: rebolus with 40 u/kg and increase rate by 2 u/kg/h.

if aptt is 45-75 seconds: continue current rate.

if aptt is 76-90 seconds: decrease rate by 2 u/kg/hr.

if aptt is > 90 seconds: hold heparin for one hour and then decrease rate by 3 u/kg/h.

part i: convert the patient's weight to kg: ____ kg

calculate the initial heparin bolus dosage: _____ u

calculate the bolus dose: ____ ml

calculate the initial heparin infusion rate: ____ u/h or ____ ml/h

part ii: at 0930, the patient's aptt is 77 seconds. according to the protocol, what will your action be?

no promises here but...

Convert the patient's weight to kg: 56.82 kg

Calculate the initial heparin bolus dosage: 4545.6 units

Calculate the bolus dose: 4.55 mL

Calculate the initial heparin infusion rate: 1022.76 units/hr or 1.02 ml/hr

and then I'd decrease the rate to 0.91 ml/hr

no promises that it's correct I did it real quick lol

Specializes in Med/Surg, Ortho, ASC.

Thank you, but what formula did you use?

the wt sure is correct, but lol am so confused,on decreasing the rate part

but geeeeeeezzzzzzz thank you

Specializes in ICU & LTAC as RN. FNP.

I believe your initial rate would be 10.2 ml/hr, then decrease to 9.1 ml/hr. You need to figure how many units per cc are in the bag. 25000/250=100 units per cc. You multiply pt wt x 18 to get the initial hourly dose of 1022 units/hr. Divide 1022/100 (# of units per cc as stated above) =10.2 ml/hr. When you need to decrease the hourly rate, in this case by 2u/kg/hr you would now recalculate using pt weight x 16 = 909.09 to give you the new hourly dose. Now do 909.09/100= 9.09 or 9.1 ml/hr.

By the way, did you notice you titled this thread insulin calc help, lol.

Specializes in ICU & LTAC as RN. FNP.

I believe your initial rate would be 10.2 ml/hr, then decrease to 9.1 ml/hr. You need to figure how many units per cc are in the bag. 25000/250=100 units per cc. You multiply pt wt x 18 to get the initial hourly dose of 1022 units/hr. Divide 1022/100 (# of units per cc as stated above) =10.2 ml/hr. When you need to decrease the hourly rate, in this case by 2u/kg/hr you would now recalculate using pt weight x 16 = 909.09 to give you the new hourly dose. Now do 909.09/100= 9.09 or 9.1 ml/hr.

By the way, did you notice you titled this thread insulin calc help, lol.

Lol, guess i started confusing myself from the time i tittled it insulin calc helo :), oh well thank you

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Lol, guess i started confusing myself from the time i tittled it insulin calc helo :), oh well thank you
...

The title says insulin (to control blood sugar for diabetics)....the question is heparin (blood thinner for clot prevention).........that being said you need to know your conversion factors. there are 2.2 lbs per Kg. divide 125 by 2.2 and get your kg weight..........

http://www.dosagehelp.com/

here is a really good website for drug calculations and teaching yourself. Calculations are very important to nursing everyday. Learn how to early.....;)

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