HIT: occurs when antibodies develop against Heparin and platelet factor 4 complex. Greater than 80 seconds: at risk for bleeding…decrease rate and may need to turn off drip for a period of time (again depends on the Heparin protocol in place) Less than 60 seconds: NOT therapeutic…may need an increase in rate and/or a bolus (depends on the Heparin protocol in place) 
Therapeutic level for patients on Heparin: 1.5 – 2.5 times the normal range ( about 60-80 seconds). Monitor aPTT (activated partial thromboplastin time) : Here are some Heparin drip calculations for practice. It’s weight-based (always obtain a current and accurate weight for proper dosing). Intravenous: if on a continuous IV drip, the patient will be on a Heparin drip protocol, which will have very specific guidelines on how to titrate the drip to keep the patient’s clotting levels therapeutic. Injection (subcutaneous): administer 2 inches away from belly button, 1 inch away from scars, rotate injection sites, do NOT massage or rub area. Work on intrinsic pathway of coagulation: this pathway is normally activated by internal vascular trauma.ĭuration: Short…stays in the system for hours. Enhances the activity of antithrombin III, which will inhibit thrombin and the conversion of fibrinogen to fibrin. No contact sports, use electric razors and soft bristle toothbrushesįamily Name: indirect thrombin inhibitors. Signs and symptoms of bleeding: bleeding gums, blood in stool (dark/tarry), blood in urine (red/pink urine), coffee ground emesis etc. No aspirin, NSAIDS or over-the-counter health supplements due to the risk of bleeding…always speak with MD before taking any new medications. They slow down the clotting process but do NOTbreak up an existing clot.Ī patient can be on both of these medications at the same time until the patient’s INR level becomes therapeutic….then the Heparin will be discontinued. 
This review will highlight how the medications work, nursing considerations, antidotes, and patient education.ĭon’t forget to take the two quizzes that will test you on these medications:īoth are anticoagulants.
As a nursing student, you must be familiar with the differences and similarities between these two anticoagulants.
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