Heparin is a blood thinner,a part of Anticoagulants family.
Heparin antidote is PROTAMINE SULFATE.
LABORATORY TESTS for the actions of heparin is PTT known as Partial Thromboplastin Time.
Heparin interferes with the formation of fibrin thereby preventing clots to form. It is only available to be given SQ or intravenously (IV). There is no heparin by mouth(po). The most frequently used heparin is the subQ.
Why do we give?.Why is heparin used.It is use for pulmonary embolism, CAD,Patient on prolonged bed rest,DVT,Valve disorders, Atrial fibrillation and Cerebral disease.
SubQ is used to prevent blood clots in prolonged Bedrest patients who have been bed ridden for a long time. Rotate sites during injection, please avoid injecting on a bruised surface. Tuberculin syringes are recommended.
Used to keep heparin lock and the central lines patency.
It is temporary used most of the time. Once patient starts to Ambulate discontinue heparin.
ONSET :IV Rapid onset with intravenous use is 5 to 10minute.
DURATION: Short duration of 2 to 6hours.
Half life : 60 to 90minutes šāāļø
Intravenously used to prevent further clots in a patient with clotting problems such as DVT or pulmonary embolism.
Nurses Responsibilities:
1.Monitor patient PTT closely. Ideally keep the levels 2 to 2.5 times the control.
2.Report immediately any signs and symptoms of bleeding.
3.Refrain from any traumatizing procedures that can lead to bleeding or bruising.
4.ALWAYS calculate drips and use a pump to administer heparin solution. Patient who received thombolytic treatment may also receive heparin to help facilitate thrombolysis.Thrombolysis therapy are alteplase and reteplase.Simply follow doctor orders. Sometimes the doctor order might be to give heparin subQ. Also additional blood thinners such as aspirin might be ordered.
Check the lab values notify doctor for changes in condition. After the critical or crisis period passed. The doctor might start patient on Warfarin or lovenox. Educate patient on how to inject lovenox ( Must be given in lower abdomen for better absorption)and to monitor for signs and symptoms of bleeding and bruising. Rotation sites on the lower abdomen. Do not give in the arm. Call and notify the doctor.
Heparin bag.Must do a drip calculation with another nurse.Unsplashed.com
5.Monitor Platelet counts for thrombocytopenia.
DO NOT GIVE HEPARIN IF HEMOGLOBIN IS LESS THAN 7,AND DON’T GIVE PATIENT WITH LOW PLATELETS. CALL AND NOTIFY THE DOCTOR. REASON PATIENT MIGHT BLEED OUT.
If Platelet is less than 50 there will be bruises and bleeding so do not give.Normal platelets count ranges from 150,000 to 450,000 platelets. Study your heparin, and understand it very well.Study your Furosemide, Coumadin. They always show up at the NCLEX. And you will meet them at work as a nurse.
Thrombocytopenia Platelet counts is less than 150,000.
Thrombocytosis the Platelet counts is greater than 450,000.
Other blood thinners.
Fondaparinux (Arixtra)
Apixaban (Eliquis)
Dabigatran(Pradaxa)
Edoxaban(savaysa)Heparin (Fragmin Innohep and Lovenox)
Rivaroxaban.
Warfarin (Coumadin, Jantoven)Blood thinners help blood to flow very smoothly in the veins and arteries. They prevent blood clotting getting bigger or clot formation.
Nurses You Move Me 