Nr40 Medication Math Test Page 5
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1231. ORDER:
Lidocaine 1mg/min as a continuous infusion
AVAILABLE:
Lidocaine 2 grams/ in 250 ml D5W administered on an infusion pump
ADMINISTER: ___________________________________
32. ORDER:
Dopamine 5mcg/kg/min as a continuous infusion
Patient’s weight 176 lbs.
AVAILABLE:
Dopamine 400mg in 500 ml D5W administered on an infusion pump
ADMINISTER: ___________________________________
______________________________________________________________________________________
Use the following physician orders to answer questions.
Pre-printed Orders for Continuous Heparin Infusions
Date:
Time:
a.m./p.m.
1.
Do not use Heparin Protocol if patient, not on previous anticoagulant therapy, has an INR > 1.3 and /or PTT> 35
seconds at baseline.
2.
Obtain PT/PTT stat if not already drawn within the past 24 hours.
3.
administer Heparin 5000 units IV Bolus stat
4.
Start standard heparin infusion 25000 units /250 ml of D5W at:
1,200 units/hour patients >100 kg
1,000 units/hour patients 80-100 kg
800 units/hour patients <80 kg
5.
Place order for repeat PTT under Heparin Protocol in computer system.
6.
If patient on Coumadin, obtain PT daily and call results to MD
7.
If patient is receiving both Coumadin and Heparin and INR > 2.5 STOP IV HEPARIN and call MD
8.
Titrate to keep PTT between 45-75 seconds using the following:
HEPARIN ADJUSTMENT NOMOGRAM
PTT
BOLUS (UNITS)
STOP INFUSION
RATE CHANGE
REPEAT PTT
(ML/HR)
< 40
3000
0 min.
+1
5+ hours
40-44
0
0 min
+0.5
5+ hours
45-75
0
0 min
0 (no change)
Next am
76-85
0
0 min
- 0.5
Next am
86-100
0
30 min
-1
5+ hours
101-120
0
60 min
-1.5
5+ hours
>120
0
60 min
-3
5+ hours
NOTE: ANTICIPATED REDRAW TIME IS 5-12 HOURS
33.
You are caring for a client who has the above orders placed on their chart to initiate the heparin protocol. The
morning results of the client’s baseline PTT is 25 seconds. The INR 1.0. What would you do next?
___________________________________________________________
34.
You are preparing to administer the bolus and have available heparin 10000 units/ml.
How many milliliters
would you prepare to administer? _________________
35.
The client weighs 218 pounds. How many units per hour would you initiate? ____________
36.
What would you program the infusion pump at? _____________________
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