You are administering heparin and following the protocol bel…

You are administering heparin and following the protocol below for a client weighing 251 lbs. The order is to administer an initial heparin IV bolus followed by a titrated IV infusion.  Round to the tenths place. HEPARIN PROTOCOL Initial bolus- 60 units/kg Initial rate – 12 units/kg/h Obtain a PTT every 6 hours, and adjust dosage and rate as follows: If a PTT is less than 35 secs:      Repeat bolus with 40 units/kg and increase the rate by 4 units/kg/h. If a PTT is 36 to 44 seconds:       If a PTT is 36 to 44 seconds:          Repeat bolus with 20 units/kg and increase the rate by 2 units/kg/h. If a PTT is 45 to 75 seconds:       Continue current rate. If a PTT is 76 to 90 seconds:       Decrease rate by 2 units/kg/h. If a PTT is greater than 90 secs: Hold the heparin for 1 hour and decrease rate by 3 units/kg/h. Available (for bolus)  – heparin 1,000 units/mLAvailable (for infusion) –  heparin 25,000 units in 250 mL D5   6 hours later the PTT results from the lab are- PTT 80 secs.  The client is currently receiving 12units/kg/hr. What rate will the nurse set the pump at for the titrated heparin IV infusion in response to the PTT of 80 secs.

A client with COPD tells a nurse that he feels short of brea…

A client with COPD tells a nurse that he feels short of breath. During the assessment, the nurse noted wheezing, RR 30, O2 sat of 86%, BP 130/88. The nurse calls the respiratory therapist to administer an ordered nebulizer treatment. The therapist says, “I have several more nebulizer treatments to do on the unit where I am now. As soon as I’m finished, I’ll come and assess the client.” What is the nurse’s most appropriate action?