Heparin

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Hi, I wanted to know your opinion. We give our patients heparin prophalactically. But I wanted to know would you hold it with someone with a low hemoglobin 8.0 and platelets 75 and going through chemo? I chose to hold it and the doctor agreed with me but my charge nurse wasn't sure what to do. What do you think? Does heparin affect Hgb?

I've had doctors have me hold it for surgery. Why should I not hold it???

Because they need intraop dvt ppx, and prophylactic heparin does not cause clinically significant bleding

For outpatients, anesthesia will give 5000u heparin subq after intubation

I work on a post surg unit (we obviously get preop too!) and we do hold anticoagulants prior to surgery, even aspirin most of the time.

Ok, here is another question I have. When a patient is NPO with Q 6 accuchecks do you hold the insulin even if their blood sugar is high? I have seen it where you do not and have seen it where you do. Or do you just default to the physician? My charge nurse said it has to be held because the patient is NPO but then I have seen it given. What do you think???

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