Author Question: A patient receiving IV heparin therapy for a deep vein thrombosis (DVT) in his right calf asks why ... (Read 32 times)

penza · **on:** Jul 24, 2018

A patient receiving IV heparin therapy for a deep vein thrombosis (DVT) in his right calf asks why his calf remains painful, edematous, and warm to touch after 2 days of anticoagulant therapy. Which response by the nurse is most accurate?

a. It takes at least 3 days for the symptoms to resolve once the clot dissolves.
b. Heparin does not dissolve blood clots but neutralizes clotting factors, preventing extension of the clot and the possibility of it traveling elsewhere in your body.
c. I will report this to your health care provider because there may be a need to look at alternative treatments.
d. You appear anxious. The health care provider will eventually put you on ticlopidine, which allows for an earlier discharge.

Question 2

A patient is receiving 1400 units of heparin/hour on an IV pump. The aPTT time is 54. The laboratory control is 25. Which action by the nurse is accurate?

a. Bolus the patient with an additional 5000 units of heparin.
b. Stop the heparin immediately and notify the health care provider that the patient's blood level is toxic.
c. Administer protamine sulfate stat.
d. Continue with the prescribed rate.

djofnc · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

ANS: B
Heparin is used to treat a thromboembolism and promote neutralization of activated clotting factors, preventing the extension of thrombi and the formation of emboli. Heparin will minimize tissue damage by preventing it from developing into an insoluble, stable thrombus. It is inappropriate to tell a patient how long it will take to dissolve a clot. The patient's question does not warrant notification of the health care provider. Telling the patient that the health care provider will be starting the patient on ticlopidine is inappropriate and inaccurate.

Answer to Question 2

ANS: D
Therapeutic heparin values are 1.5 to 2.5 times the control value. The therapeutic range of heparin with a control of 25 is 37.5 to 62.5 units/hour. A time of 54 is within the therapeutic range. An increase of heparin is not indicated because the patient is in the therapeutic range. The range is not toxic. An antidote to the anticoagulant is not indicated because the patient is within the therapeutic range.