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

Inject heparin at a 90-degree angle into the abdomen, at least 2 inches away from the umbilicus.

Inject heparin at a 45-degree angle into the deltoid muscle, aspirating before injecting.

Inject heparin at a 90-degree angle into the thigh, rotating sites between left and right legs.

Inject heparin at a 45-degree angle into the upper arm, massaging the site after injection.

Answer and Explanation

The Correct Answer is A

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.

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Correct Answer is D

Explanation

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.

A. Protamine sulfate should be given slowly intravenously within 30 minutes of heparin administration. B. Protamine sulfate should be given rapidly intramuscularly within 60 minutes of heparin administration. C. Protamine sulfate should be given slowly intravenously within 60 minutes of heparin administration. D. Protamine sulfate should be given rapidly intramuscularly within 30 minutes of heparin administration.

Correct Answer is A

Explanation

Protamine sulfate should be given slowly intravenously within 30 minutes of heparin administration. This is because protamine sulfate is a strong base that neutralizes the anticoagulant effect of heparin, which is a strong acid. Protamine sulfate should be given within 30 minutes of heparin administration to prevent excessive bleeding or hemorrhage.Protamine sulfate should be given slowly intravenously to avoid adverse effects such as hypotension, bradycardia, pulmonary edema, and anaphylaxis.

Choice B is wrong because protamine sulfate should not be given rapidly or intramuscularly.Rapid administration can cause severe hypotension and shock, and intramuscular administration can cause local irritation and hematoma formation.

Choice C is wrong because protamine sulfate should not be given more than 60 minutes after heparin administration.The half-life of heparin is 60 to 90 minutes, and the anticoagulant effect of heparin will usually wear off within a few hours after discontinuation.Giving protamine sulfate after 60 minutes may cause excess anticoagulation or “heparin rebound” due to the longer half-life of protamine sulfate.

Choice D is wrong for the same reasons as choice B.Protamine sulfate should not be given rapidly or intramuscularly.

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

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

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?

Correct Answer is A

Explanation

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

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.

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?