Pediatrics and Heparin IV Calculations -- Please Help!

[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!! :)

[Chrono, BSN, RN]

It could also be the reason stated by janfrn, which I hadn't ever seen before, though I'm still just a student myself.

[Laurie52]

Sorry! The baby weighs 3.605 kg.

So do you want to know how fast to run the drip or how much is going in at a specified rate?

[Esme12, ASN, BSN, RN]

moved to nursing student assistance for best results.... janfrn is right something isn't right.

[Jeana18, MSN, DNP, RN, APRN, NP]

I need to find the Safe Dose Range for Heparin in 0.225% NaCl. To check to see if the order from the MD is okay to use on the newborn (I.e. the drip rate, amount of units, so forth). Sorry this is so confusing my professor didnt really explain to me what was wrong she just said figure it out and recalculate.

[Double-Helix, BSN, RN]

Probably the most important piece of information that you need to know is WHY is your patient receiving heparin? Is it to maintain IV patency? Or is it due to a cardiac condition, hypercoagulability, etc.? Once you know the reason why the patient is receiving the heparin, it will be much easier to figure out if the correct concentration is indeed 1unit/mL or if you copied it incorrectly.

[Jeana18, MSN, DNP, RN, APRN, NP]

The infant was receiving it for IV line maintenance. Which is why I'm confused as to how my numbers are incorrect as stated by my instructor.

[Double-Helix, BSN, RN]

Perhaps I'm not understanding the problem. You found a safe reference range of 28units/kg/hour. Your patient's dose is 2units/hour. How many units/kg/hour is that?. Is this a safe dose?

Maybe you could find an article about continuous low-dose heparin infusions to maintain IV patency in neonates and show your instructor.