Cardiac Question #13


The nurse is caring for an acutely ill patient with a history of renal insufficiency who is on anticoagulant therapy. What will the nurse anticipate in the individualized plan of care for the heparin therapy?


  1. Heparin is contraindicated in the treatment of this patient.
    • Rationale:
  2. Heparin may be administered subcutaneously, but not IV.
    • Rationale:
  3. Lower doses of heparin are required for this patient.
    • Rationale:
  4. Coumadin will be substituted for heparin.
    • Rationale:



Clients with renal compromise have a higher risk of both thrombotic and/or bleeding complications because of renal clearance of the drug. Dose adjustments such as lower dose of heparin will be required. Route of administration of heparin will not influence the plan of care for renal insufficiency. Heparin is not contraindicated; however, it must be dosed correctly and monitored frequently. Coumadin does not need to replace heparin.

Learning Outcomes

Test Taking Tip

Video Rationale