The nurse caring for a client in the intensive care unit reports a critical laboratory value of 120,000/mm³ (120 x 10⁹/L) platelets, decreased from 300,000/mm³ (300 x 10⁹/L) on admission. The health care provider says this is normal. The client is receiving heparin injections. Which nursing action would be the most appropriate?

Question

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There are 2 forms of heparin-induced thrombocytopenia. The first form (platelets >100,000/mm³ [100 x 10⁹/L]) normalizes within a few days. The second form (platelets <40,000/mm³ [40 x 10⁹/L]) is a life-threatening autoimmune process that requires immediate heparin discontinuation. When in doubt of a clinician's judgment, the nurse should document these objections and report to the nursing supervisor. (Options A, C, and D) It is important to first refer up the nursing hierarchy. Educational objective: The nurse should document and then report objections about a clinician's judgment to the nursing supervisor.

The Nurse Caring for a Client in the Intensive Care