A patient who has end-stage kidney disease is hospitalized for apotassium level of 6.3 mEq/L. The patient has a tunneled dialysiscatheter in place for hemodialysis, which is done three times aweek. On assessment, the patient states that he is anuric. Hisblood pressure is 107/59 mm Hg, heart rate is 69/min, respirationson room air are 22/min, and temperature is 37.5 C (99.5 F). Hispulse oximeter reading is 93% at rest. The patient’s lungs areauscultated clear bilaterally in both upper lobes anteriorly andposteriorly, and diminished bilaterally in the lower lobesanteriorly and posteriorly. A bio-occlusive dressing is in placeover the tunneled catheter that is clean, dry, and intact. Thereare no signs or symptoms of infection at the insertion site of thecatheter. The patient denies any shortness of breath or chest pain.Peaked T waves are noted on ECG, and physician has been notified.Current labs indicate a blood urea nitrogen level of 62 mg/dL and acreatinine level of 3.7 mg/dL. Upon admission to the room, thepatient is oriented to the use of the call light that was placedwithin reach, his top side rails are placed in the up position onboth sides, and all surrounding floor space is clear. The bed is inthe lowest position. The patient is instructed to call the nursefor assistance when he wants to sit in the chair or requiresbathroom assistance. He states understanding and is able todemonstrate the correct use of the call light. The physician hasprescribed one ampule of bicarbonate IV and 4 units of regularinsulin IV.
What concentration of heparin should be used to lockhemodialysis catheters?
