A nursing student is preparing to give a pregnant woman heparin for a deep vein thrombosis (DVT). The student questions the dose, as it is higher than what the student has given to other patients. What response by the perinatal nurse is most appropriate?
A. Have the student hold the dose and double-check the order with the provider.
B. Inform the student that physiological changes in pregnancy require higher doses.
C. Remind the student that large doses are needed to dissolve the existing clot.
D. Tells the student to administer the dose and check results of the next laboratory draw.
ANS: B
The pregnant patient has a greater plasma volume and an increased renal clearance (due to increased blood flow to the kidneys). The combination of normally occurring heparin-binding proteins along with the breakdown of heparin often results in the need for higher doses of heparin during pregnancy.
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