Pharmacology Anticoagulants #8

Question

The nurse is caring for a patient who has a new order for heparin therapy. Which nursing assessment data is priority to evaluate prior to beginning heparin therapy?

Answers

  1. Serum blood glucose
    • Rationale:

      This answer is not correct because although serum blood glucose is good to obtain, it is not the priority with the medication administration of heparin anticipated. The blood glucose is not directly affected during heparin therapy. The therapeutic goal of heparin is to reduce clotting, so the patients baseline activated partial thromboplastin (aPTT) time is obtained. This will reveal if it is safe to administer this medication but mostly utilized to adjust or titrate heparin dosages during therapy. The aPTT levels will be mon

  2. Serum potassium and sodium levels
    • Rationale:

      This answer is not correct because although knowing that the patient’s electrolytes are within normal range is important, it is not the priority with the medication administration of heparin anticipated. The electrolytes are not directly affected during heparin therapy. The therapeutic goal of heparin is to reduce clotting, so the patient’s baseline activated partial thromboplastin (aPTT) time is obtained. This will reveal if it is safe to administer this medication but mostly utilized to adjust or titrate heparin dosages during therapy. The aPTT

  3. Heart rate and blood pressure
    • Rationale:

      This answer is not correct because although knowing that the patient’s blood pressure and heart rate are within normal range is important, it is not the priority with the medication administration of heparin anticipated. The heart rate and blood pressure are not directly affected during heparin therapy.The therapeutic goal of heparin is to reduce clotting, so the patient’s baseline activated partial thromboplastin (aPTT) time is obtained. This will reveal if it is safe to administer this medication but mostly utilized to adjust or titrate heparin dosages during therapy. The aPTT levels will be monitored throughout therapy.

  4. Activated partial thromboplastin time
    • Rationale:

      This answer is correct because since the therapeutic goal of heparin is to reduce clotting, the patient’s baseline activated partial thromboplastin (aPTT) time is priority to obtain. This will reveal if it is safe to administer this medication but mostly utilized to adjust or titrate heparin dosages during therapy. Heparin is an anticoagulant and therapy is indicated for patients with serious conditions, including pulmonary embolism, myocardial infarction, and other thromboembolic conditions, to help prevent further blood clots from forming. The aPTT levels will be monitored throughout therapy. If the pat

Overview

Prior to administration of heparin therapy, the patient’s baseline activated partial thromboplastin time should be obtained.

Explanation

The correct answer is D. Prior to initiating heparin therapy, the nurse should review laboratory assessment data which includes the aPTT, hematocrit, and platelet count. Such laboratory values provide baseline information on client’s clotting abilities. Electrolytes, blood sugar and vital signs will not be priority.

Learning Outcomes

Heparin is an anticoagulant and therapy is indicated for patients with serious conditions, including pulmonary embolism, myocardial infarction, and other thromboembolic conditions, to help prevent further blood clots from forming. Since the therapeutic goal of heparin is to reduce clotting, the patient’s baseline activated partial thromboplastin (aPTT) time is obtained. This will reveal if it is safe to administer this medication but mostly utilized to adjust or titrate heparin dosages during therapy. The aPTT levels will be monitored throughout therapy. If the patient’s levels indicate an overdose has occurred and dangerous bleeding is anticipated, the antidote, protamine sulfate, may be indicated.

Test Taking Tip

When handwritten, the two lower case “ts” or “tt” can look like an uppercase H, to remind the student that aPTT is associated with “H”eparin therapy not PT (which does not have the two “tts” to make an H).

Video Rationale