A patient has been receiving intravenous heparin. When laboratory tests are drawn, the nurse has difficulty stopping bleeding at the puncture site. The patient has bloody stools and is reporting abdominal pain
The nurse notes elevated partial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT). Which action will the nurse perform?
a. Ask for an order for oral warfarin (Coumadin).
b. Obtain an order for protamine sulfate.
c. Request an order for vitamin K.
d. Suggest that the patient receive subcutaneous heparin.
ANS: B
Protamine sulfate is given as an antidote to heparin when patient's clotting times are elevated. Oral warfarin will not stop the anticoagulant effects of heparin. Vitamin K is used as an antidote for warfarin. Administering heparin by another route is not indicated when there is a need to reverse the effects of heparin.
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