A female client with liver cirrhosis and chronic anemia is hospitalized for a deep venous thrombosis. The client is receiving a heparin infusion and suddenly develops epistaxis. Which laboratory value would indicate that the heparin infusion needs to be turned off?

Question

A female client with liver cirrhosis and chronic anemia is hospitalized for a deep venous thrombosis.  The client is receiving a heparin infusion and suddenly develops epistaxis.  Which laboratory value would indicate that the heparin infusion needs to be turned off?

Quizplus · Accepted Answer

Heparin is an anticoagulant that helps prevent further clot formation. It is titrated based on a partial thromboplastin time (PTT). The therapeutic PTT target is 1.5-2.0 times the normal reference range of 25-35 seconds. A PTT value >100 seconds would be considered critical and could result in life-threatening side effects. Common sentinel events that result from heparin drips include epistaxis, hematuria, and gastrointestinal bleeds. (Option A) A normal hematocrit for a female is 35%-47% (0.35-0.47). In a client with a history of chronic anemia, a hematocrit of 30% (0.30) may be an expected finding. (Option C) A normal platelet count is 150,000-400,000/mm³ (150-400 x 10⁹/L). In a client with a history of liver cirrhosis, a platelet count of 80,000/mm³ (80 x 10⁹/L) would be anticipated. An episode of bleeding rarely occurs with a platelet count >50,000 mm³ (50 x 10⁹/L). (Option D) A normal prothrombin time is 11-16 seconds, and so a level of 11 seconds would not be concerning. Educational objective: Heparin infusions require close monitoring by the nurse. The partial thromboplastin time is the laboratory value required to accurately monitor the therapeutic effects of heparin.

A Female Client with Liver Cirrhosis and Chronic Anemia Is