The nurse is providing care for a client who developed heparin-induced thrombocytopenia (HIT) during heparin therapy
The nurse is aware that lepirudin (Refludan) is often given to clients with this condition. Which assessment findings should the nurse report to the medical team?
Standard Text: Select all that apply.
1. The most recent aPTT is 2.8.
2. The client's last stool tested positive for blood.
3. The client is allergic to eggs.
4. The client's spleen was removed after a motor vehicle accident 3 years ago.
5. The client drinks 5–6 cups of coffee daily.
Correct Answer: 1,2
Rationale 1: Lepirudin is contraindicated if the aPTT is above 2.5.
Rationale 2: Lepirudin is contraindicated in clients who are actively bleeding.
Rationale 3: There is no contraindication to the use of lepirudin in clients with egg allergy.
Rationale 4: A surgery 3 years ago is not a contraindication to the use of lepirudin, nor is absence of the spleen.
Rationale 5: There is no contraindication to the use of lepirudin in those who drink coffee.
Global Rationale: Lepirudin is contraindicated if the aPTT is above 2.5 or if the client is actively bleeding. There is no contraindication to the use of lepirudin in clients with egg allergy or for those who drink coffee. A surgery 3 years ago is not a contraindication to the use of lepirudin, nor is absence of the spleen.
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