Question

I. Read Chapters 49 to 52 from your Text Book and PP 

II. NCLEX Review Questions Chapters 49 to 52 from Evolve Resources 

III. Case Study: Ms. J had right hip replacement surgery 3 days ago. She was on low-dose heparin therapy to prevent DVT. On initial assessment of the patient, the nurse finds her right calf to be tender to palpation with a red, warm vein on the posterior surface. The nurse reports this finding, and Ms. Jis diagnosed with DVT of the right calf. She is placed on IV heparin therapy and bed rest. 

1. What actions should the nurse take before administering the IV heparin? 

2. What medication should the nurse have on hand for a patient receiving IV heparin therapy? 

3. When evaluating Ms. J's daily blood test results, the nurse notes decreasing hematocrit and blood cell counts, an aPTT of 90 seconds, and a platelet count of 95,000. How does the nurse interpret these findings?

Answer 1

III. 1. Actions before administering heparin

• Check for any allergies, active bleeding, and bleeding tendencies.
• Baseline laboratory values such as hemoglobin, hematocrit, platelet count, activated Partial thromboplastin time (aPTT), and PTT should be checked before heparin administration.
• Check for hyperlipidemia
• Assess peripheral perfusion
• Perform renal function tests.

2. Protamine sulfate, which is used as an antidote for heparin overdose.

3. aPTT normal value is 30 - 40 seconds. If 90 seconds it indicates bleeding disorder, to liver disease. A low platelet count of 95,000 shows Heparin-induced Thrombocytopenia because of the destruction of the platelets. Decreased hematocrit and blood cell count are also heparin-induced.