Heparin Nursing Considerations and Patient Teaching [Drug Guide]

Heparin is a critical medication that nurses must understand to ensure patient safety. Learn why it’s essential for nurses to have in-depth knowledge of heparin in this article.

Table of Contents

• What is Heparin?
  • Generic Name
  • Brand Names
  • Drug Classification of Heparin
• Indications and Therapeutic Effects
• Mechanism of Action
• Precautions and Contraindications
• Drug Interactions
  • Drug-Drug
  • Drug-Natural Products
  • Drug-Food
• Adverse Effects
• Administration Considerations
  • Available Forms
  • Dosage for Neonates
  • Dosage for Children
  • Dosage for Adults
• Pharmacokinetics
• Nursing Considerations for Heparin
  • Nursing Assessment
  • Nursing Diagnosis
  • Heparin Nursing Interventions
  • Patient Education and Teaching
  • Evaluation and Desired Outcomes
• Recommended Resources
• See Also

What is Heparin?

Heparin is a medication that is commonly used in hospitals to prevent blood clots from forming. It works by inhibiting the clotting factors in the blood and is usually given as an injection or through an intravenous (IV) infusion. Heparin is typically used in patients who are at high risk of developing blood clots, such as those who have had surgery, are bedridden, or have certain medical conditions.

Generic Name

• heparin

Brand Names

Heparin is available under various brand names, including:

• Hepalean
• Heparin Lock Flush
• Hep-Lock
• Hep-Pak
• Liquaemin
• Calciparine
• Innohep
• Normiflo
• Clexane
• Fragmin
• Klexane

Drug Classification of Heparin

Therapeutic Class

• anticoagulants

Pharmacologic Class

• antithrombotics

Indications and Therapeutic Effects

Heparin is primarily used to prevent and treat blood clots in a variety of medical conditions, including:

1. Deep vein thrombosis (DVT). A blood clot in a deep vein, usually in the leg

2. Pulmonary embolism (PE). A blood clot that travels to the lungs

3. Atrial fibrillation. An irregular heartbeat that can cause blood clots to form in the heart

4. Heart attack. Heparin can be used in combination with other medications to prevent further clots from forming in the heart

5. Stroke. Heparin may be used to prevent and treat blood clots that can cause a stroke

6. Certain types of surgery. Heparin may be used to prevent blood clots from forming during and after surgery

7. Kidney dialysis. Heparin is used to prevent blood clots from forming in the dialysis machine.

Mechanism of Action

The mechanism of action of heparin involves its ability to bind to and enhance the activity of a naturally occurring protein called antithrombin III. Antithrombin III is a potent inhibitor of several clotting factors, including thrombin and factor Xa, which are key components in the formation of blood clots.

When heparin binds to antithrombin III, it causes a conformational change in the protein that allows it to more effectively inactivate these clotting factors. This results in the prevention of the formation of new blood clots and the enlargement of existing ones, which can help prevent serious medical conditions like deep vein thrombosis, pulmonary embolism, and stroke.

The exact mechanism of action of heparin can vary depending on the type of heparin used, the dose, and the individual patient. However, all forms of heparin work by enhancing the activity of antithrombin III, which in turn inhibits the activity of several clotting factors and prevents the formation of blood clots.

Precautions and Contraindications

While heparin can be an effective medication for preventing and treating blood clots, it is important to take certain precautions and be aware of any contraindications before using it. Some important considerations include:

Precautions

1. Bleeding. Heparin can increase the risk of bleeding, especially in patients with a history of bleeding disorders, ulcers, or recent surgery. It is important to monitor patients for signs of bleeding and adjust the dose of heparin as needed.

2. Hepatic or renal impairment. Heparin is cleared from the body by the liver and kidneys, so patients with impaired liver or kidney function may require a lower dose or more frequent monitoring.

3. Pregnancy and breastfeeding. heparin is generally considered safe for use during pregnancy and breastfeeding, but it is important to discuss any potential risks with a healthcare provider.

4. Elderly patients. older patients may be more sensitive to the effects of heparin, so it may be necessary to adjust the dose or monitor more frequently.

5. Ulcer disease. Heparin could make ulcers worse and cause dangerous bleeding.

Contraindications

1. Hypersensitivity. Patients with a known hypersensitivity to heparin should not use the medication.

2. Active bleeding. Heparin should not be used in patients with active bleeding, including bleeding disorders and recent surgery.

3. Severe thrombocytopenia. Heparin can cause a decrease in platelet count, so it should not be used in patients with severe thrombocytopenia (low platelet count).

4. Uncontrolled hypertension. Heparin can increase blood pressure, so it should be used with caution in patients with uncontrolled hypertension.

Drug Interactions

Heparin is a common medication used to prevent blood clots, but it can interact with other drugs, leading to potential complications.

Drug-Drug

While heparin can be an effective medication for preventing blood clots, it can also interact with other drugs and lead to potentially dangerous side effects. Some of the most common drug interactions for heparin include:

1. Aspirin and other NSAIDs. Taking heparin with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen can increase the risk of bleeding.

2. Warfarin and other anticoagulants. Combining heparin with other blood-thinning medications such as clopidogrel can also increase the risk of bleeding, and can be particularly dangerous in individuals with certain medical conditions.

3. Thrombolytic agents. Thrombolytic agents, such as streptokinase or alteplase, can increase the risk of bleeding when used with heparin.

4. Digoxin. Heparin can increase the level of digoxin in the blood, which can lead to potentially dangerous side effects.

5. Antibiotics. Certain antibiotics, such as tetracyclines, can decrease the effectiveness of heparin.

Drug-Natural Products

While heparin can be an effective medication for preventing blood clots, certain natural products can interact with heparin and cause potential complications. Some of the natural products that can interact with heparin include:

1. Garlic. Garlic is a natural product that can reduce blood clotting, which can be potentially dangerous when used with heparin.

2. Ginkgo biloba. Ginkgo biloba is a natural supplement that can increase the risk of bleeding when used with heparin.

3. Vitamin E. Vitamin E is a natural supplement that can increase the risk of bleeding when used with heparin.

4. Omega-3 fatty acids. Omega-3 fatty acids, such as those found in fish oil supplements, can also increase the risk of bleeding when used with heparin.

Drug-Food

It is also important to be aware of the drug-food interactions of heparin, as some foods can interact with heparin and affect its effectiveness. Some of the foods that can interact with heparin include:

1. Vitamin K-rich foods. Vitamin K is a nutrient that helps the blood to clot. Foods that are rich in vitamin K, such as leafy green vegetables, can reduce the effectiveness of heparin.

2. Alcohol. Alcohol can thin the blood and increase the risk of bleeding. When used with heparin, alcohol can increase the risk of bleeding and other potential complications.

3. Grapefruit. Grapefruit contains compounds that can interfere with the breakdown of certain medications, including heparin. This can lead to higher levels of heparin in the bloodstream and increase the risk of bleeding.

Adverse Effects

Heparin is a widely used medication for preventing blood clots, but it can also have side effects and adverse effects.

Common Side Effects of Heparin

While heparin can be an effective medication for preventing blood clots, it can also have side effects. Some of the common side effects of heparin include:

• Bruising or bleeding at the injection site
• Mild allergic reactions such as rash, itching, or hives
• Nausea or vomiting
• Hair loss

In addition to the common side effects, heparin can also have more serious adverse effects. Some of the adverse effects of heparin include:

1. Thrombocytopenia. A condition where the blood has a lower-than-normal number of platelets, which can lead to an increased risk of bleeding.

2. Hemorrhage. Excessive bleeding can occur, especially if the dose of heparin is too high.

3. Osteoporosis. Long-term use of heparin can cause bone loss, leading to osteoporosis.

Administration Considerations

Available Forms

• Solution for injection: 10 units/mL, 100 units/mL, 1000 units/mL, 5000 units/mL, 7500 units/mL, 10,000 units/mL, 20,000 units/mL, 40,000 units/mL.
• Pre-mixed solution: 1000 units/500 mL, 2000 units/1000 mL, 12,500 units/250 mL, 25,000 units in 250 and 500 mL.

Dosage for Neonates

Therapeutic Anticoagulation

• IV (Neonates and Infants <1 yr)
  • Continuous infusion — Loading dose 75 units/kg, followed by 28 units/kg/hr, adjust to maintain aPTT of 60 – 85 sec.

Cardiovascular Surgery

• Intra-arterial (Neonates & Infants)
  • 100 – 150 units/kg via an artery prior to cardiac catheterization.

Arterial Line Patency

• Intra-arterial (Neonates)
  • 0.5 – 2 units/mL.

Dosage for Children

Therapeutic Anticoagulation

• IV (Children >1 yr)
  • Intermittent bolus — 50 – 100 units/kg, followed by 50 – 100 units/kg q 4 hr.
  • Continuous infusion — Loading dose 75 units/kg, followed by 20 units/kg/hr, adjust to maintain aPTT of 60 – 85 sec.

Cardiovascular Surgery

• Intra-arterial (Children)
  • 100 – 150 units/kg via an artery prior to cardiac catheterization.

Line Flushing

• IV (Children)
  • 10 – 100 units/mL (10 units/mL for infants <10 kg, 100 units/mL for all others) solution to fill heparin lock set to needle hub; replace after each use.

Total Parenteral Nutrition

• IV (Children)
  • 0.5 – 1 units/mL (final solution concentration) to maintain line patency.

Dosage for Adults

Therapeutic Anticoagulation

• IV (Adults)
  • Intermittent bolus — 10,000 units, followed by 5000 – 10,000 units q 4 – 6 hr.
  • Continuous infusion — 5000 units (35 – 70 units/kg), followed by 20,000 – 40,000 units infused over 24 hr (approx. 1000 units/hr or 15 – 18 units/kg/hr).
• Subcut (Adults)
  • 5000 units IV, followed by initial subcut dose of 10,000–20,000 units, then 8000 – 10,000 units q 8 hr or 15,000 – 20,000 units q 12 hr.

Prophylaxis of Thromboembolism

• Subcut (Adults)
  • 5000 units q 8 – 12 hr (may be started 2 hr prior to surgery).

Cardiovascular Surgery

• IV (Adults)
  • At least 150 units/kg (300 units/kg if procedure <60 min; 400 units/kg if >60 min).

Line Flushing

• IV (Adults)
  • 10 – 100 units/mL (10 units/mL for infants <10 kg, 100 units/mL for all others) solution to fill heparin lock set to needle hub; replace after each use.

Total Parenteral Nutrition

• IV (Adults)
  • 0.5 – 1 units/mL (final solution concentration) to maintain line patency.

Pharmacokinetics

The pharmacokinetics of heparin is a complex process that involves absorption, distribution, metabolism, and excretion. Understanding the pharmacokinetic profile of heparin is essential for determining the appropriate dosage, frequency of administration, and duration of treatment.

1. Absorption. Heparin is not orally bioavailable and cannot be absorbed from the gastrointestinal tract. It is typically administered parenterally, either by subcutaneous or intravenous injection. When administered subcutaneously, heparin is absorbed slowly and incompletely. Peak plasma concentrations are usually reached within 4 hours, and the bioavailability ranges from 30% to 70%. On the other hand, intravenous administration results in rapid and complete absorption of heparin, with peak plasma concentrations achieved within minutes.

2. Distribution. Once absorbed, heparin is distributed throughout the body. It binds to plasma proteins such as antithrombin III and circulates in the bloodstream. The volume of distribution for heparin is about 0.07 L/kg, indicating that it is largely confined to the plasma compartment. However, heparin can also accumulate in organs such as the liver, spleen, and lungs, and it can cross the placenta and enter fetal circulation.

3. Metabolism. Heparin is not metabolized by the liver or other organs. Instead, it is cleared from the body primarily by renal excretion. Heparin is cleared from the plasma with a half-life of 1 to 2 hours, and it is eliminated from the body within 8 to 12 hours after administration. In patients with impaired renal function, the clearance of heparin may be reduced, leading to an increased risk of bleeding.

4. Excretion. Heparin is primarily excreted by the kidneys, with approximately 30% of the drug being excreted unchanged in the urine. The remainder is metabolized into smaller fragments that are cleared by the kidneys. Heparin clearance is directly proportional to renal function, and patients with impaired renal function may require a reduced dosage of heparin to avoid the risk of bleeding.

Nursing Considerations for Heparin

As a nurse, it is essential to have a thorough understanding of the nursing considerations for heparin administration to ensure safe and effective patient care.

Nursing Assessment

Heparin is a commonly used medication in various healthcare settings, primarily to prevent and treat blood clots. As a nurse, it is essential to perform a comprehensive nursing assessment before administering heparin to ensure safe and effective patient care.

1. Review patient’s medical history.
Before administering heparin, a thorough medical history should be performed. The medical history should include a review of the patient’s current medications, allergies, and medical conditions, such as bleeding disorders or liver or kidney disease.

2. Perform physical assessment including vital signs.
Before administering heparin, a thorough physical assessment should be performed. The physical assessment should include a detailed assessment of the patient’s vital signs, including heart rate, blood pressure, respiratory rate, and oxygen saturation.

3. Obtain baseline coagulation studies.
Baseline coagulation studies, including the prothrombin time (PT), activated partial thromboplastin time (aPTT), and platelet count, should be obtained before heparin administration. These baseline values serve as a reference for monitoring the therapeutic effect of heparin and detecting any adverse effects, such as bleeding or thrombocytopenia.

4. Assess for signs of bleeding and hemorrhage such as bleeding gums, nosebleeds, unusual bruising, black tarry stools, hematuria, fall in hematocrit or BP, and guaiac-positive stools.
Assessing the patient’s bleeding risk is crucial before administering heparin. A comprehensive bleeding risk assessment includes evaluating the patient’s medical history, such as prior bleeding episodes, recent surgery, or trauma. The assessment should also include a physical examination, including inspection of the skin and mucous membranes for signs of bleeding.

5. Assess for potential drug interactions.
Heparin can interact with other medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and antiplatelet agents, which can increase the risk of bleeding. Nurses should assess the patient’s medication history and monitor for potential drug interactions when administering heparin.

6. Monitor patient for hypersensitivity reactions such as chills, fever, and urticaria.
The most common type of heparin hypersensitivity is the delayed-type hypersensitivity reaction (DTHR), a type IV allergic reaction characterized by itchy eczema and plaques at the injection sites. Seldom they turn into maculopapular exanthema. Other hypersensitivity reactions are rare but may be life-threatening such as skin necrosis because of heparin-induced thrombocytopenia.

7. Monitor platelet count every 2–3 days throughout therapy.
Heparin may cause mild thrombocytopenia, which appears on 4th day and resolves despite continued heparin therapy. Heparin-induced thrombocytopenia (HIT), a more severe form that necessitates discontinuing medication, may develop on 8th day of therapy; may reduce platelet count to as low as 5000/mm3 and lead to increased resistance to heparin therapy.

8. Monitor for hyperkalemia and increase in AST and ALT levels.
Anticoagulation with heparin rarely causes elevated serum potassium through a reduction in the number and affinity of adrenal angiotensin II receptors, causing reversible aldosterone suppression, thereby leading to enhanced sodium excretion and hyperkalemia.

9. Monitor heparin toxicity.
Protamine sulfate is the antidote. Due to short half-life, an overdose can often be treated by withdrawing the drug.

Nursing Diagnosis

Nursing diagnoses for patients receiving heparin may vary depending on the patient’s medical history, medication regimen, and therapeutic indications. However, here are some possible nursing diagnoses for patients receiving heparin:

1. Ineffective tissue perfusion. Ineffective tissue perfusion related to decrease in the delivery of oxygen and nutrients to the tissues.

2. Risk for injury. Risk for injury related to bleeding tendencies which can lead to injury and tissue damage.

3. Risk for bleeding. Risk for bleeding related to heparin therapy, as evidenced by elevated activated partial thromboplastin time (aPTT), prolonged prothrombin time (PT), and low platelet count.

4. Risk for impaired skin integrity. Risk for impaired skin integrity related to potential adverse effects of heparin therapy, such as ecchymosis, petechiae, or hematoma formation.

5. Risk for infection. Risk for infection related to frequent monitoring of coagulation studies, requiring repeated venipunctures.

6. Noncompliance. Noncompliance related to lack of understanding or education about the medication, its purpose, and potential side effects.

Heparin Nursing Interventions

1. Carefully examine all heparin sodium injection vials to confirm the correct vial choice prior to administration.
Fatal hemorrhages have occurred in pediatric patients due to errors in which heparin sodium injection vials were confused with heparin flush vials.

2. Have second practitioner independently check original order, dose calculation, and infusion pump settings.
By checking the original order, the healthcare provider can ensure that the correct medication and dose are prescribed for the patient’s condition. The dose calculation is important because the correct dose of heparin is based on the patient’s weight and medical history, among other factors. Finally, the infusion pump settings must be set correctly to ensure that the right amount of medication is administered at the right rate over the correct duration of time

3. Review patient’s recent (emergency department, operating room) and current medication administration records before administering any heparin or LMW heparin product.
Unintended concomitant use of two heparin products (unfractionated heparin and LMW heparins) has resulted in serious harm or death.

4. Inform all personnel caring for patient of anticoagulant therapy.
Venipunctures and injection sites require application of pressure to prevent bleeding or hematoma formation. Also to avoid IM injections of other medications because hematomas may develop.

5. Oral anticoagulant therapy should be instituted 4 – 5 days prior to discontinuing heparin therapy.
By instituting oral anticoagulant therapy 4-5 days before discontinuing heparin therapy, it allows enough time for the oral anticoagulant to reach its full therapeutic effect while the patient is still receiving heparin therapy. This helps to ensure that the patient remains adequately anticoagulated during the transition period, reducing the risk of blood clots.

Intravenous Administration

1. Subcut
Administer deep into subcut tissue. Alternate injection sites between arm and the left and right abdominal wall above the iliac crest. Inject entire length of needle at a 45°- or 90°-angle into a skin fold held between thumb and forefinger; hold skin fold throughout injection. Do not aspirate or massage. Rotate sites frequently. Do not administer IM because of danger of hematoma formation. Solution should be clear; do not inject solution contain- ing particulate matter.

2. IVPush
Diluent: Administer loading dose undiluted.
Concentration: Varies depending upon vial used.
Rate: Administer over at least 1 min. Loading dose given before continuous infusion.

3. Continuous Infusion
Diluent: Dilute 25,000 units of heparin in 250 – 500 mL of 0.9% NaCl or D5W. Premixed infusions are already diluted and ready to use. Admixed solutions stable for 24 hr at room temperature or if refrigerated. Premixed infusion stable for 30 days once overwrap removed.
Concentration: 50 – 100 units/mL.
Rate: Adjust to maintain therapeutic aPTT. Use an infusion pump to ensure accuracy.

4. Flush
To prevent clot formation in intermittent infusion (heparin lock) sets, inject dilute heparin solution of 10 – 100 units/0.5 – 1 mL after each medication injection or every 8 – 12 hr. To prevent incompatibility of heparin with medication, flush lock set with sterile water or 0.9% NaCl for injection before and after medication is administered.

5. Y-Site Compatibility
acetaminophen, acetylcysteine, acyclovir, alemtuzumab, alfentanil, allopurinol, amifostine, aminocaproic acid, aminophylline, amphotericin B lipid complex, amphotericin B liposome, anidulafungin, argatroban, ascorbic acid, atropine, azathioprine, azithromycin, aztreonam, benztropine, bivalirudin, bleomycin, bumetanide, buprenorphine, butorphanol, calcium chloride, calcium gluconate, cangrelor, carboplatin, carmustine, cefazolin, cefotaxime, cefotetan, cefoxitin, ceftaroline, ceftazidime, ceftriaxone, cefuroxime, chloramphenicol, cisplatin, cladribine, clindamycin, cyanocobalamin, cyclosporine, cytarabine, dactinomycin, daptomycin, dexamethasone, dexmedetomidine, digoxin, docetaxel, dopamine, doxacurium, doxapram, doxorubicin liposome, enalaprilat, ephedrine, epinephrine, epoetin alfa, eptifibatide, ertapenem, estrogens, conjugated, etoposide, etoposide phosphate, famotidine, fenoldopam, fentanyl, fluconazole, fludarabine, fluorouracil, folic acid, foscarnet, fosphenytoin, ganciclovir, gemcitabine, glycopyrrolate, granisetron, hydrocortisone, hydromorphone, ifosfamide, imipenem/cilastatin, indomethacin, irinotecan, isoproterenol, ketorolac, leucovorin, lidocaine, linezolid, lorazepam, magnesium sulfate, mannitol, mechlorethamine, melphalan, meropenem, mesna, metaraminol, methotrexate, methoxamine, methyldopate, methylergonovine, metoclopramide, metoprolol, metronidazole, micafungin, midazolam, milrinone, mitomycin, morphine, moxifloxacin, multiple vitamins, nafcillin, nalbuphine, naloxone, neostigmine, nitroglycerin, nitroprusside, norepinephrine, octreotide, ondansetron, oxacillin, oxaliplatin, oxytocin, paclitaxel, palonosetron, pamidronate, pancuronium, pemetrexed, penicillin G, pentobarbital, phenobarbital, phentolamine, phenylephrine, phytonadione, piperacillin/tazobactam, potassium acetate, potassium chloride, procainamide, prochlorperazine, promazine, propofol, propranolol, pyridostigmine, pyridoxine, ranitidine, remifentanil, rituximab, rocuronium, sargramostim, scopolamine, sodium acetate, sodium bicarbonate, streptokinase, succinylcholine, sufentanil, tacrolimus, theophylline, thiamine, thiopental, thiotepa, tigecycline, tirofiban, tolazoline, tranexamic acid, trastuzumab, trimethaphan, vasopressin, vecuronium, verapamil, vinblastine, vincristine, voriconazole, warfarin, zidovudine, zoledronic acid.

6. Y-Site Incompatibility
alteplase, amiodarone, amsacrine, caspofungin, ciprofloxacin, dantrolene, daunorubicin hydrochloride, diazepam, diazoxide, doxycycline, epirubicin, filgrastim, haloperidol, hydroxyzine, idarubicin, ketamine, levofloxacin, mitoxantrone, mycophenolate, palifermin, papaverine, pentamidine, phenytoin, protamine, quinupristin/ dalfopristin, reteplase, tobramycin.

7. Additive Compatibility
It is recommended that heparin not be mixed in solution with other medications when given for anticoagulation, even those that are compatible because changes in rate of heparin infusion may be required that would also affect admixtures.

Patient Education and Teaching

Patients receiving heparin should receive education about the medication, its therapeutic effects, potential adverse effects, and the importance of compliance with the prescribed dosage and frequency of administration. Patients should also be advised to report any signs of bleeding or unusual bruising to the nurse or physician immediately.

1. Advise patient to report any symptoms of unusual bleeding or bruising to physician immediately.
It is important to be aware of the potential side effect of unusual bleeding or bruising. This can include things like nosebleeds, bleeding gums, or easy bruising.

2. Tell patient to be aware of the signs of potential drug interaction, such as unusual bleeding or bruising.
While heparin can be an effective medication for preventing blood clots, it can also interact with other drugs and lead to potentially dangerous side effects.

3. Instruct patient not to take medications containing aspirin or NSAIDs while on heparin therapy.
Taking heparin with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen can increase the risk of bleeding.

4. Tell patient to be cautious when using natural products that can increase the risk of bleeding, and monitor symptoms closely.
Certain natural products can interact with heparin and cause potential complications.

5. Caution patient to avoid IM injections and activities leading to injury and to use a soft toothbrush and electric razor during heparin therapy.
These can interfere with the body’s blood clotting ability. If a patient receives an IM injection or experiences an injury while on heparin therapy, it can increase the risk of bleeding, which can be dangerous or even life-threatening in some cases.

6. Tell patient to be cautious when consuming vitamin K-rich food.
Vitamin K is a nutrient that plays a key role in blood clotting, and consuming too much of it can interfere with the effects of heparin, which is an anticoagulant. Foods that are high in vitamin K include leafy green vegetables (such as spinach, kale, and collard greens), broccoli, brussels sprouts, cabbage, asparagus, and some types of vegetable oils.

7. Advise patient to inform healthcare professional of medication regimen prior to treatment or surgery.
Certain medications and supplements can interact with heparin, potentially increasing the risk of bleeding or other complications.

8. Tell patient to avoid consuming alcohol while using heparin, as alcohol can increase the risk of bleeding and other potential complications.
It is advisable to avoid drinking alcohol while using heparin because alcohol can increase the risk of bleeding. Additionally, excessive alcohol consumption can lead to liver damage, and since the liver helps process heparin, drinking alcohol can potentially affect the effectiveness of the medication.

9. Tell patient to not consume grapefruit or grapefruit juice while using heparin, as they can interact with the medication and increase the risk of bleeding.
Grapefruit and grapefruit juice should be avoided while using heparin because they can interact with the medication and increase the risk of bleeding. Grapefruit contains compounds that can inhibit the breakdown of certain medications in the body, including heparin. This can lead to higher levels of heparin in the bloodstream, which can increase the risk of bleeding.

10. Patients on anticoagulant therapy should carry an identification card with this information at all times.
Carrying an identification card can help ensure that patients receive appropriate medical treatment in emergency situations and can help prevent potentially harmful interactions with other medications or procedures. Patients should also inform their family members and close contacts about their anticoagulant medication and the importance of carrying an identification card.

Evaluation and Desired Outcomes

Here are some desired outcomes for heparin therapy:

1. Prevention or resolution of blood clots. The primary desired outcome of heparin therapy is the prevention or resolution of blood clots. This can be assessed through diagnostic testing, such as ultrasound or blood tests, to measure the presence and severity of blood clots.

2. Reduction in symptoms. Heparin can alleviate symptoms associated with blood clots, such as pain, swelling, and redness. Desired outcomes include a reduction in these symptoms as treatment progresses.

3. Minimization of complications. Heparin therapy can sometimes lead to complications, such as bleeding or bruising. Desired outcomes include minimizing these complications while still effectively treating the blood clots.

4. Improvement in quality of life. Heparin therapy can significantly impact a patient’s quality of life, both physically and emotionally. Desired outcomes include an improvement in quality of life, such as being able to perform daily activities with less difficulty and having a positive outlook on the future.

5. Patency of IV catheters. IV catheters are used to administer heparin and other medications, and keeping them functioning properly is crucial for effective treatment.

6. Prolonged partial thromboplastin time (PTT) of 1.5 – 2.5 times the control, without signs of hemorrhage. A prolonged partial thromboplastin time (PTT) of 1.5 – 2.5 times the control, without signs of hemorrhage, is a desired outcome of heparin therapy.

Recommended Resources

Our recommended nursing pharmacology resources and books:

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase which will help support us. Thank you! For more information, check out our privacy policy.

See Also

Here are other nursing pharmacology study guides:

• Nursing Pharmacology – Study Guide for Nurses
  Our collection of topics related to nursing pharmacology
• Pharmacology Nursing Mnemonics & Tips
  These nursing mnemonics aim to simplify the concepts of pharmacology through the use of a simple, concise guide.
• Generic Drug Name Stems Cheat Sheet
  Learn about these generic drug name stems to help you make sense of drugs easier!
• Common Drugs and Their Antidotes
  A guide to drug antidotes that nurses should be familiar about.
• IV Fluids and Solutions Guide & Cheat Sheet
  Get to know the different types of intravenous solutions or IV fluids in this guide and cheat sheet.
• Drug Dosage Calculations NCLEX Practice Questions (100+ Items)
  Care to take the challenge? This quiz aims to help students and registered nurses alike grasp and master the concepts of medication calculation.

Drug Guides ^NEW!

Individual drug guides and nursing considerations for the most common medications used in nursing pharmacology:

• Acetaminophen (Tylenol)
• Aspirin
• Atorvastatin (Lipitor)
• Enoxaparin (Lovenox)
• Furosemide (Lasix)
• Gabapentin
• Hydromorphone (Dilaudid)
• Lisinopril
• Metoprolol
• Morphine