Question

1. A patient comes from surgery after a femoral bypass with a heparin drip running through a pump. What nursing assessments should be made to monitor this patient's postoperative progress? The operative record indicates that the patient has had a total of 50,000 units of heparin during the operative procedure. The postoperative orders do not state a specific rate of flow for the heparin drip, which is currently running through the pump at 8 mL/hr. What actions should be taken by the nurse? ti-factrr Ka or aP (goal: 1.S-a.s

Answer 1

1.The following nursing assessment to be done

• Assess the pedal pulse to ensure blood circulation
• Assess the limb for any coolness,cyanosis,numbness because this indicates lack of blood circulation
• Monitor patients vital signs ,as changes in blood pressure can be observed
• Maintain a strict intake and output chart to take measure to prevent any fluid loss or excess
• Assess for any bleeding
• For heparin infusion check the post op order,if not specified inform to the concerned healthcare provider ,surgeon,anesthetist to adjust the rate of heparin.Usually in post operative stahe th3 heparin has to be continued

2.The order has to be checked>wash hands>administer injection subcutaneously>documen it

Observe the patient for any pain,redness ,tenderness at the site of injection,bleeding,blood investigation during the course of therapy

3.The laboratory tests like

• Anti factor Xa determines the coagulation factor if the patient and helpful reading on administration of this drug
• Monitoring of CBC (thrombocytopeniato be assess)
• Serum creatinine level

4.The premedication assessment should be on the following

• Ruling for any drug allergy
• Any heamtological problems or disease
• On any blood thinners
• Use of medication for arthritis,sedatives,hypertensive medications.