Medical Surgical Labs Coagulation Panel #3

Question

The nurse is caring for a client who is receiving a heparin infusion. Coagulation studies reveal the client to have aPTT of 46 sec. What action should the nurse take next?

Answers

  1. Contact the health care provider.
    • Rationale:

      This answer is not correct because contacting the healthcare provider is unnecessary. A client receiving heparin should have aPTT between 46-70 sec.

  2. Prepare protamine sulfate.
    • Rationale:

      This answer is not correct because the protamine sulfate is an antidote for heparin and not needed at this time. Protamine sulfate is a medication used to reverse the effects of heparin and this client’s aPTT is within the therapeutic range while on heparin.

  3. Stop the infusion.
    • Rationale:

      This answer is not correct because an aPTT between 46-70 sec for a client receiving heparin is within the therapeutic range. It is safe for the nurse to continue the infusion.

  4. Continue the infusion.
    • Rationale:

      This answer is correct because the client’s lab is within normal range for receiving heparin. The nurse should continue with the infusion of heparin. The infusion should be stopped and the healthcare provider notified only if the aPTT becomes over 70 sec.

Overview

Normal heparin values for aPTT are between 46-70 sec while the client is receiving heparin. If the aPTT goes over 70 sec, the infusion should be stopped and the HCP should be notified and labs reassessed in one hour.

Explanation

Learning Outcomes

Heparin is an anticoagulant that treats and prevents blood clots. The lab study most used to monitor heparin is the aPTT. The normal range for an aPTT is 30-40 sec and 46-70 sec for the client receiving heparin. Anything over 70 sec is considered critical. The infusion should be stopped and the healthcare provider notified. Protamine sulfate is the antidote to heparin. This will be given slowly over 10 minutes intravenously. The labs will be reassessed in one hour after ceasing the infusion.

Test Taking Tip

Understand that for a client not on heparin, aPTT should be between 30-40 sec and for the client receiving heparin, 46-70 sec.

Video Rationale