A client's intravenous heparin drip rate will be increased at 1400. The nurse plans to draw an activated partial thromboplastin time (aPTT) at which time?
1. Immediately after increasing the rate
2. At 2000
3. At 1530
4. At 0800 the next morning
Correct Answer: 2
Rationale 1: If drawn immediately, the aPTT will reflect the level from the lower dosage.
Rationale 2: The most accurate representation of aPTT from the new rate will occur at least 6 hours after a rate increase.
Rationale 3: At 1530, the aPTT will reflect a mix of the old rate and the new rate.
Rationale 4: Waiting until 0800 the next morning is dangerous because the heparin dose may be too high.
Global Rationale: The most accurate representation of aPTT from the new rate will occur at least 6 hours after a rate increase. If drawn immediately, the aPTT will reflect the level from the lower dosage. At 1530, the aPTT will reflect a mix of the old rate and the new rate. Waiting until 0800 the next morning is dangerous because the heparin dose may be too high.
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