Question

A patient who has been receiving a heparin infusion and warfarin (Coumadin) for a deep vein thrombosis (DVT) is diagnosed with heparin-induced thrombocytopenia (HIT) when her platelet level drops to 110,000/µL. Which action will the nurse include in the plan of care?

a. Use low-molecular-weight heparin (LMWH) only.
b. Administer the warfarin (Coumadin) at the scheduled time.
c. Teach the patient about the purpose of platelet transfusions.
d. Discontinue heparin and flush intermittent IV lines using normal saline.

Answer 1

In the care of a patient with heparin-induced thrombocytopenia (HIT), the nurse should discontinue heparin and flush IV lines with saline. Other forms of heparin, including LMWH, should be avoided, and warfarin may also be discontinued.

Step-by-step explanation:

A patient diagnosed with heparin-induced thrombocytopenia (HIT) after receiving a heparin infusion for deep vein thrombosis (DVT), should have all forms of heparin discontinued immediately. This condition occurs when the immune system forms antibodies against heparin when it is bound to a protein called platelet factor 4 (PF4), causing an abnormal drop in platelets. The correct action to include in the plan of care for a patient with HIT is to discontinue heparin and flush intermittent IV lines using normal saline. Using low-molecular-weight heparin is not advised, as it can further trigger HIT. Warfarin (Coumadin) could potentially worsen the risk of thrombosis in the context of HIT and should be discontinued if platelet counts are significantly low. Platelet transfusions are typically avoided in HIT unless there is significant bleeding, as they can increase the risk of thrombosis.