A nurse is educating a client who is prescribed low molecular weight heparin (LMWH) for home use. The client asks, “What is the difference between LMWH and regular heparin?” What is an appropriate response by the nurse?

“LMWH has a lower risk of bleeding than regular heparin.”

“LMWH does not require frequent blood tests like regular heparin.”

“LMWH has a more predictable effect than regular heparin.”

All of the above.

Answer and Explanation

The Correct Answer is D

Low molecular weight heparin (LMWH) is a type of anticoagulant medication that prevents blood clots.

LMWH has several advantages over regular heparin, such as:

• LMWH has a lower risk of bleeding than regular heparin. LMWH has a more specific action on the clotting factors and less effect on platelets, which reduces the risk of bleeding complications.

• LMWH does not require frequent blood tests like regular heparin. LMWH has a more predictable and consistent effect than regular heparin, which means that the dose does not need to be adjusted based on blood tests. Regular heparin requires frequent monitoring of the activated partial thromboplastin time (aPTT) to ensure therapeutic levels.

• LMWH has a more predictable effect than regular heparin. LMWH has a longer half-life and a higher bioavailability than regular heparin, which means that it works more reliably and lasts longer in the body. Regular heparin has a variable response and can be affected by factors such as age, weight, and renal function.

Therefore, the nurse should explain to the client that LMWH is a safer and more convenient option than regular heparin for home use.

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Correct Answer is A

Explanation

Inject heparin at a 90-degree angle into the abdomen, at least 2 inches away from the umbilicus.This is the appropriate technique for administering subcutaneous heparin, as it ensures that the drug reaches the fat layer under the skin and reduces the risk of bleeding and bruising.

Choice B is wrong because heparin should not be injected into the deltoid muscle, as it may cause tissue damage and nerve injury.Heparin should also not be aspirated before injecting, as it may cause hematoma formation.

Choice C is wrong because heparin should not be injected at a 90-degree angle into the thigh, as it may cause pain and irritation.The thigh is also not a preferred site for heparin injection, as it has less fat tissue than the abdomen.

Choice D is wrong because heparin should not be injected at a 45-degree angle into the upper arm, as it may cause nerve damage and hematoma formation.Heparin should also not be massaged after injection, as it may increase the risk of bleeding and bruising.

A. Stop the heparin infusion immediately. B. Administer protamine sulfate as ordered. C. Notify the health care provider of the result. D. Draw a prothrombin time (PT) and international normalized ratio (INR) level. E. Monitor the client for signs and symptoms of bleeding.

Correct Answer is ["A","B","C"]

Explanation

A. Stop the heparin infusion immediately.This is correctbecause heparin is an anticoagulant that prevents blood clotting by inhibiting the formation of thrombin.

The activated partial thromboplastin time (aPTT) is a test that measures how long it takes for the blood to clot.

The normal range for aPTT is25 to 35 seconds.

A high aPTT indicates that the blood is taking too long to clot, which increases the risk of bleeding.

Therefore, the heparin infusion should be stopped to prevent further bleeding.

•

B. Administer protamine sulfate as ordered.This is correctbecause protamine sulfate is an antidote for heparin overdose.

It binds to heparin and neutralizes its anticoagulant effect.

Protamine sulfate should be administered as ordered by the health care provider to reverse the heparin overdose and restore normal clotting time.

•

C. Notify the health care provider of the result.This is correctbecause the health care provider should be informed of the abnormal aPTT result and the actions taken by the nurse.

The health care provider may order further tests or adjust the heparin dosage or frequency based on the client’s condition and response to treatment.

•

D. Draw a prothrombin time (PT) and international normalized ratio (INR) level.This is wrongbecause PT and INR are tests that measure the effect of warfarin, another anticoagulant, on blood clotting.

They are not affected by heparin and are not relevant for this client.

•

E. Monitor the client for signs and symptoms of bleeding.This is wrongbecause this is not an appropriate action in this situation.

The nurse should not wait for signs and symptoms of bleeding to occur, but should act immediately to stop the heparin infusion, administer protamine sulfate, and notify the health care provider.

Monitoring for bleeding is a preventive measure that should be done before and during heparin therapy, not after an overdose has occurred.

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A nurse is educating a client who is prescribed low molecular weight heparin (LMWH) for home use. The client asks, “What is the difference between LMWH and regular heparin?” What is an appropriate response by the nurse?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer subcutaneous heparin to a client with deep vein thrombosis. What is the appropriate technique for this procedure?

Correct Answer is A

Explanation

A nurse is reviewing the laboratory results of a client who is receiving intravenous unfractionated heparin. The nurse notes that the client’s activated partial thromboplastin time (aPTT) is 120 seconds. What are the appropriate nursing actions in this situation? Select all that apply.

Correct Answer is ["A","B","C"]

Explanation

A nurse is administering protamine sulfate to a client who has received an overdose of heparin. What are some important nursing considerations for this medication?

A nurse is caring for a client who develops heparin-induced thrombocytopenia (HIT) while receiving unfractionated heparin for pulmonary embolism. The nurse anticipates that the health care provider will order which of the following medications to treat this condition?

A nurse is educating a client who is prescribed low molecular weight heparin (LMWH) for home use. The client asks, “What is the difference between LMWH and regular heparin?” What is an appropriate response by the nurse?