Therapeutic level for Heparin - Need Help

[healthcare4life]

I came across this:

Since the pt's PTT is at the therapeutic level, would the nurse not anticipate the doctor to D/C the infusion?

By the way, the correct answer for this question is #4.But why would you want to leave the rate of infusion as is?

PS: The rationale mentioned behind this question did not explain the reason behind the answer.

Thanks for any response.

[mindlor]

I came across this:

Since the pt's PTT is at the therapeutic level, would the nurse not anticipate the doctor to D/C the infusion?

By the way, the correct answer for this question is #4.But why would you want to leave the rate of infusion as is?

PS: The rationale mentioned behind this question did not explain the reason behind the answer.

Thanks for any response.

If the heparin is dc'd then the aPtt will return to normal and the client will again be at risk for DVT. In my opinion the question is worded poorly. It states the client is being treated for DVT. My understanding is that heparin prevents clots from forming and has no clot busting ability........SO MANY QUESTiONS worded poorly....all through nursing school........

Anyway, hospital have a heparin protocol that keys off of the aPtt, usually the heparin drip is left running if the aPtt is in range......

Do a search on heparin drip protocol

[FORTHELOVEOF!!!!]

Sorry if I say something you already know, just going to give you my understanding of Heparin and Heparin therapy. I was taught that heparin is fast acting but short lived, so (depending on your books and institutions) you want to keep heparin levels at 65 sec or greater. If you were to check a patient aPTT and it were way to high, you would stop the IV and recheck in an hour. The reason I said this is because we wouldn't check the levels in an hour if we didn't expect there to be a drastic decline in the levels, so if you were to stop therapy on a person who is at the therapeutic level, in an hours time they could be well below and at a risk for clots. So as long as your patient is at a therapeutic level you would keep the IV running until it is d/c. There is usually standing orders in every hospital as to how often to check heparin levels to make sure it doesn't get above that therapeutic level.

Hope this helps

[healthcare4life]

Thanks guys. With my mentality, I was thinking the other way around: Since it's an IV infusion, keeping the hep infusion will increase the PTT time which places the patient at increased risk for bleeding.

I know that there's certain protocols for different hospitals, but I'm studying for the NCLEX and just wanted to get a good grasp about this confusing question.

[mindlor]

As I said before, it is worded poorly. By my reckoning, heparin is used to prevent, not to treat DVT

[FORTHELOVEOF!!!!]

"As I said before, it is worded poorly. By my reckoning, heparin is used to prevent, not to treat DVT"

It is used to both treat and prevent DVT.

[mindlor]

Deep vein thrombosis (DVT): Treatments and drugs - MayoClinic.com

Ok cool I see it now....

The "blood thinners" treat it by preventing it from getting bigger, allowing the body time to absorb the clot/s...

The only breakout the clot busters (streptokinase for the really gnarly clots.....

TY for helping me see it :)

[MN-Nurse, ASN, RN]

"As I said before, it is worded poorly. By my reckoning, heparin is used to prevent, not to treat DVT"

It is used to both treat and prevent DVT.

Yup. Show up with PE or DVT and you win a heparin gtt.

[SunshineDaisy, ASN, RN]

I guess I'm the odd one out. I would have picked 4 as well because the aPTT is in the therapeutic range, so whatever level the heparin is set at leave it there.

[FORTHELOVEOF!!!!]

Your not the odd one out, we all agreed that it was the right answer, the OP was just asking why it was the right answer.

[elle21]

The thera range is 1.5-2.5x times the control. In this case, 30 is the control. So, therapeutic range is 45-75. 65 is in that range, so leaving it alone is the correct answer.