Medical Surgical Labs Coagulation Panel #1

Question

The nurse receives an order for heparin on a client who has an INR of 4.5 sec. What action should the nurse take?

Answers

  1. Prepare to administer the drug.
    • Rationale:

      This answer is correct because for a client taking heparin, the nurse should not focus on INR. The lab to monitor is PTT, the platelet count. Platelets for a client on heparin should be between 150,000 – 400,000 and PTT 30-40 seconds.

  2. Hold the order and contact the HCP.
    • Rationale:

      This answer is not correct because INR lab is to be observed when a client is taking warfarin. Warfarin is an anticoagulant and values should be between 2 – 3 sec.

  3. Hold the order and retest labs.
    • Rationale:

      This answer is not correct because there is no reason to retest the lab. A client with a high INR is not at risk for bleeding if they are taking heparin.

  4. Contact pharmacy and question the order.
    • Rationale:

      This answer is not correct because when the nurse wants to question an order, the HCP should be notified, not the pharmacy, since the HCP is the one who wrote the order. There is no reason for the nurse to question this order.

Overview

Heparin is an anticoagulant that reduces blood clotting. The lab to monitor for heparin is PTT which measures how long it takes for a blood clot to form.

Explanation

Learning Outcomes

Heparin is an anticoagulant that reduces blood clotting. The lab to monitor for heparin is PTT, which measures how long it takes for a blood clot to form. Therapeutic range of PTT for a client on heparin is between 46-70 sec. Platelets should be between 150,000 and 400,000. Another important lab to note for heparin is platelets. Platelets are blood cells that help the blood clump together to prevent bleeding. Low platelets increase the bleeding risk. INR is testing when clients are taking warfarin.

Test Taking Tip

Remember with heparin, you monitor PTT. A memory trick is that heparin begins with “H” and the “TT” in PTT appears similar to the letter H.

Video Rationale