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 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. “Warfarin, which is an oral anticoagulant that works by blocking vitamin K.” B. “Aspirin, which is an antiplatelet agent that works by inhibiting cyclooxygenase.” C. “Argatroban, which is a direct thrombin inhibitor that works by binding to thrombin.” D. “Streptokinase, which is a thrombolytic agent that works by converting plasminogen to plasmin.”

Correct Answer is C

Explanation

Argatroban, which is a direct thrombin inhibitor that works by binding to thrombin. This is because argatroban is an alternative anticoagulant that can be used for patients with HIT, as it does not cause platelet aggregation or activation. Argatroban directly inhibits thrombin, which is the enzyme that converts fibrinogen to fibrin and activates platelets.

Choice A is wrong because warfarin, which is an oral anticoagulant that works by blocking vitamin K, is contraindicated in patients with HIT, as it can cause skin necrosis and limb gangrene due to microvascular thrombosis.

Warfarin also has a delayed onset of action and requires monitoring of the international normalized ratio (INR).

Choice B is wrong because aspirin, which is an antiplatelet agent that works by inhibiting cyclooxygenase, is also contraindicated in patients with HIT, as it can increase the risk of bleeding and does not prevent thrombosis.

Aspirin also has a long-lasting effect on platelet function and can interact with other drugs.

Choice D is wrong because streptokinase, which is a thrombolytic agent that works by converting plasminogen to plasmin, is not indicated for patients with HIT, as it can cause severe bleeding complications and allergic reactions.

Streptokinase also has a short half-life and requires continuous infusion.

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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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