A physician ordered 1/4 strength Isomil 12 oz via nasogastric tube over 6 hours. How much solvent (water) will be needed?

Given:

Ordered dose of Heparin: 18 units/kg/hr

Patient weight: 123 pounds

Concentration of Heparin: 25,000 units/250 mL (100 units/mL)

Step 1: Convert patient weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Patient weight in kg = 123 lbs x 0.453592 kg/lb = 55.7923 kg

Step 2: Calculate the total dose of Heparin in units/hr:

Total dose (units/hr) = Ordered dose (units/kg/hr) x Patient weight (kg)

Total dose (units/hr) = 18 units/kg/hr x 55.7923 kg

Total dose (units/hr) = 1004.2614 units/hr

Step 3: Calculate the infusion rate in mL/hr:

Infusion rate (mL/hr) = Total dose (units/hr) / Concentration (units/mL)

Infusion rate (mL/hr) = 1004.2614 units/hr / 100 units/mL

Infusion rate (mL/hr) = 10.042614 mL/hr

Step 4: Round to the nearest tenths:

Infusion rate (mL/hr) ≈ 10.0 mL/hr

A) There is an increased risk of hyperthyroidism:
High levels of LDL cholesterol are not associated with hyperthyroidism. Hyperthyroidism is a condition related to an overactive thyroid gland, which affects metabolism and hormone levels but does not directly impact LDL cholesterol levels.

B) There is an increased risk of heart disease:
LDL cholesterol, often referred to as "bad cholesterol," contributes to the buildup of fatty plaques in the walls of arteries, a process known as atherosclerosis. This buildup can narrow and harden the arteries, leading to reduced blood flow and increasing the risk of heart disease, including conditions such as coronary artery disease, heart attack, and stroke. High LDL levels are considered one of the most significant modifiable risk factors for cardiovascular disease.

C) There is the possibility of digestive problems:
While very high cholesterol levels can sometimes contribute to the formation of gallstones, high LDL cholesterol levels are not directly linked to digestive problems. The primary concern with high LDL is its contribution to cardiovascular disease rather than digestive health.

D) There is an increased risk of rhabdomyolysis:
Rhabdomyolysis is a condition caused by the breakdown of muscle tissue, which can lead to the release of muscle proteins into the bloodstream. While certain medications used to lower cholesterol, such as statins, can cause muscle pain and, in rare cases, lead to rhabdomyolysis, high LDL itself is not a direct cause of rhabdomyolysis. The main health concern with high LDL is its contribution to heart disease.