Question

The client diagnosed with a DVT is on a heparin (an anticoagulant) drip at 1,400 units per hour, and Coumadin (warfarin sodium; also an anticoagulant) 5 mg twice a day. Which intervention should the nurse implement first?

a. Check the PTT and PT/INR.
b. Check with the HCP to see which drug should be discontinued.
c. Administer both medications.
d. Discontinue the heparin because the client is receiving Coumadin.

Answer 1

The nurse's initial intervention for a client with DVT on heparin and Coumadin should be to check the PTT and PT/INR to monitor coagulation levels, before making decisions regarding the continuation or alteration of the anticoagulant medications.

Step-by-step explanation:

Intervention for a Client with DVT on Anticoagulation Therapy

When managing a client diagnosed with Deep Vein Thrombosis (DVT) who is receiving a heparin drip and Coumadin (warfarin sodium), the nurse's first intervention should be to check the PTT and PT/INR. These tests are crucial for monitoring the client's coagulation status and ensuring that the anticoagulant therapy is at a therapeutic level without causing an overdose. Checking with the healthcare provider (HCP) about discontinuing one of the drugs can follow after obtaining and evaluating the laboratory results. It is also important to note that heparin and Coumadin can be administered concurrently for a brief overlap since they have different mechanisms of action, and the transition from heparin to Coumadin therapy is common practice to ensure continuing anticoagulation.