If administered subcutaneous, know how to give it and where……. ****Heparin therapeutic range for the aPTT: 1.5-2.5 times the normal value range……example: 60-80 seconds (approximate range….varies on protocol and labs).ĪPTT less than 60? Patient is not therapeutic ( may need bolus and rate increased)ĪPTT greater than 80? Patient is at risk for bleeding (drip may be stopped for an hour (Heparin has a short half-life) and then it may be restarted at a lower rate) ****Remember in order for Heparin to work (hence prevent clots) the patient has to be THERAPEUTIC with their aPTT. It’s measured in seconds and a normal range for the aPTT is 30-40 seconds (ranges slightly vary based on the lab). So, it will assess how long it takes for certain coagulation factors to work to make a clot. This blood test measures the intrinsic and common pathways of the coagulation process. Therefore, it has a more narrow range than a PTT. They both measure the same thing, BUT aPTT has an activator added to it to speed up the clotting time for the test. Heparin is weight-based: the nurse will need to obtain a current and accurate weight on the patient’s so proper dosing can be administered.ĪPTT: activated partial thromboplastin time If the aPTT is within the therapeutic range (see range below), there is no change to the drip until the next lab draw for the aPTT.If the aPTT is too high, the patient may need the drip turned off for 1 hour and the drip rate decreased.If the aPTT is too low, the patient may need a bolus of Heparin and the drip rate increased.The Heparin drip will be titrated base on the aPTT.The aPTT will be drawn every 4-6 hours depending on the protocol. Given continuous IV: patient will be on a Heparin drip protocol with specific guidelines to follow based on the patient’s aPTT level.clot prevention with certain surgeries…example: cardiac or hipĪdministered subcutaneous or intravenous via a continuous infusion:.Atrial fibrillation (erratic heart impulses lead the heart not to empty fully and blood can pool, which forms a clot).Preventing or treating VTEs or PE (pulmonary embolism).What kind of conditions can benefit from Heparin? They just prolong how long it takes the blood to clot. It’s important to note anticoagulants do NOT dissolve or break up the clot.An embolism can also cause a stroke or heart attack. This is where the DVT broke off and travelled into circulation where it went to the lungs. Embolism: The most common type of embolism that can happen is a pulmonary embolism.It can break off and travel in circulation and when it does this it is known as an…. Deep vein thrombosis (DVT): this is where a clot forms within a vessel.When coagulation occurs abnormally, a venous thromboembolism (VTE) can occur.Result? Slows down the clotting process and helps prevent blood clots.Therefore, what’s happening is that this medication, Heparin, is binding with this natural substance (antithrombin III) in our body and amplifying how it works.When it is activated (antithrombin III) it will prevent the activation of thrombin ( which converts fibrinogen to fibrin).This substance inactivates enzymes that play a role in the clotting process. It does this by enhancing the activity of antithrombin III ( a natural substance in our body).This pathway is normally activated by internal vascular trauma.By affecting the intrinsic pathway of clotting.Heparin indirectly inhibits thrombin….HOW?.It’s part of the indirect thrombin inhibitors family, and it’s an anticoagulant.Now, using those 5 questions let’s go over what you need to know about Heparin for exam: Name? Side effects? Know the common side effects of the medicationsĮducation pieces for the patient? As the nurse we play a HUGE role in educating our patients on how to take the drug, what to watch out for, and when to call the doctor. Responsibilities as the nurse? This will tell you what your role is as the nurse and what you need to monitor in the patient. Used for? This will tell you WHY the drug was ordered…what condition is this medication treating in your patient? Name (specifically the family name)? This will tell how the drug works. Heparin (Unfractionated Heparin) Pharmacology NCLEX ReviewĪlways ask yourself these 5 questions when you see a drug name to help you understand how the drug works, your role as a nurse, and what information will be asked on an exam about the drug: It is vital the nurse knows how the drug works, side effects, how to monitor the aPTT, and education to provide to the patient etc.ĭon’t forget to take the Heparin NCLEX Question quiz. Heparin is an anticoagulant that is used to treat and/or prevent blood clots. This review will break down what you need to know for your pharmacology exams about the medication Heparin.
0 Comments
Leave a Reply. |