Heparin Therapy

[kellie127]

What is the therapeutic range for heparin, in terms of PTT? I thought it was 1.5-2 times the normal range of PTT. The normal range of PTT is 20-45 seconds right? So the therapeutic range would be 30-90? Am I thinking through this correctly? The Kaplan book is saying 55 seconds is not in therapeutic range.

[caliotter3]

The source I just saw gave detailed instructions for calculating doses and ranges based upon individual parameters for the patient. You base changes in therapy upon the initial calculation of the patient's baseline. This makes sense to me, but does not seem to be the commonly given answer. I would go with the information in your textbook and leave it at that. Whenever there are conflicting answers given, I decide which makes more sense for me and go with that one. There is no way to be right all the time when the experts can't agree.

[nicenrse]

I agree with caliotter3.....did the question mention what the pt's initial PTT was prior to therapy?

[kellie127]

No, this is the exact question:

A client is hospitalized with a dx of atrial fib. Heparin 5,000 units is ordered every 12 hours to be given subQ. The physician orders daily PTTs. The result of the client's most recent PTT is 55. Which of the following actions should be taken by the nurse?

1. Document the results and administer the heparin.

This is the answer it says because 55 is not 1.5-2 times the normal, so the med should be given. It says normal PTT is 20-45 seconds.

[nicenrse]

This is just simply a bad question. Something to know that will help ease your mind is that if nclex gives you a lab value that is abnormal then it will be way out of range and will be obviously abnormal!