A nurse is monitoring a client who is receiving intravenous heparin for angina and has a history of atrial fibrillation. Which of the following laboratory tests should the nurse use to evaluate the effectiveness of heparin therapy?

Drinking 36 oz beer daily and eating a diet high in sodium are actions that increase the risk for hypertension.

Here is why:

• Drinking too much alcohol can raise blood pressure and also damage the liver, brain, and heart.The American Heart Association recommends limiting alcohol intake to no more than one drink per day for women and two drinks per day for men.

• Eating a diet high in sodium can cause the body to retain fluid, which increases blood pressure.The American Heart Association recommends limiting sodium intake to no more than 2,300 mg per day, and ideally no more than 1,500 mg per day.

Choice A, B, and C are wrong because:

• Drinking 8 oz nonfat milk daily is not a risk factor for hypertension.In fact, dairy products may help lower blood pressure by providing calcium, potassium, and protein.

• Eating popcorn at the movie theater is not a risk factor for hypertension, unless the popcorn is heavily salted or buttered.Popcorn is a whole grain that can provide fiber and antioxidants.

• Walking 1 mile daily at 12 min/mile pace is not a risk factor for hypertension.On the contrary, physical activity can help lower blood pressure by strengthening the heart and blood vessels.

Normal blood pressure range is less than 120/80 mm Hg (millimeters of mercury).

Elevated blood pressure range is 120-129/less than 80 mm Hg.

Hypertension stage 1 range is 130-139/80-89 mm Hg.

Hypertension stage 2 range is 140 or higher/90 or higher mm Hg.Hypertensive crisis range is higher than 180/higher than 120 mm Hg.

Activated partial thromboplastin time (aPTT) is the laboratory test that the nurse should use to evaluate the effectiveness of heparin therapy.Heparin is an anticoagulant that works by helping antithrombin inactivate thrombin and factor Xa, reducing the production of fibrin and thus decreasing the formation of clots.The aPTT measures the time it takes for a clot to form in a sample of blood after adding certain substances.The normal range for aPTT is 25 to 35 seconds.A therapeutic level of heparin is 1.5 to 2.5 times the normal value, or 46 to 70 seconds.

Choice A is wrong because prothrombin time (PT) is a test that measures the time it takes for a clot to form in a sample of blood after adding tissue factor.PT is used to monitor warfarin therapy, not heparin therapy.The normal range for PT is 11 to 13 seconds.

Choice B is wrong because international normalized ratio (INR) is a standardized way of reporting the PT results, taking into account the variations in different laboratories and reagents.INR is also used to monitor warfarin therapy, not heparin therapy.The normal range for INR is 0.8 to 1.2.

Choice D is wrong because platelet count is a test that measures the number of platelets in a sample of blood.Platelets are cell fragments that help with blood clotting by sticking together and forming a plug at the site of injury.Platelet count is not directly related to heparin therapy, although heparin can cause a rare but serious adverse effect called heparin-induced thrombocytopenia (HIT), which is a drop in platelet count due to an immune reaction that leads to excessive clotting.The normal range for platelet count is 150,000 to 400,000/mm3.