Question

1. what actions should the nurse take before administering the IV heparin?

2. What medication should the nurse have on hand for a patient receiving IV heparin therapy?

3. When evaluating Ms. J’s daily blood test results, the nurse notes decreasing hematocrit and blood cell counts, an aPTT of 90 seconds, and a platelet count of 95,000. How does the nurse interpret these findings?

 

Answer 1

1. Actions to be taken before administering heparin IV therapy are to calculate dose based on the weight of the patient, to check for heparin resistance, to check for baseline laboratory values such as aPTT time, to check for hypersensitivity in patient. To check for PTT, platlet count, hematocrit. Dosing is very critical. Analog such as nomogram can be used for dose calculation.

Also patient medical history to be recorded for the presence of cardiovascular diseases, hemotologic disorders, post to spinal anesthesia etc. Heparin therapy is contraindicated in the above situations.

While administering please follow correct aseptic procedure as given in the instruction note.

2. Nurse should have protamine sulphate while starting Heparin therapy. 1% solution not exceeding 50 mg in 10 mins can be given. 1 mg of protamine will neutralise 100 IU of Heparin.

3. All the mentioned findings indicate severe hemorhage happening. Thrombocytopenia occurs in 30% of patients receiving Heparin therapy. It will occur in 2 to 20 days after start of the therapy. promptly discontinue heparin. Check for HTT and HITT . Check for alternative drug.