Page 1767 - Saunders Comprehensive Review For NCLEX-RN

c. The therapeutic dose does not

dissolve clots but prevents new
thrombus formation.
2. Blood levels
a. The normal activated partial
thromboplastin time (aPTT) is 30 to 40
seconds (conventional and SI units) in
most laboratories (values depend on
reagent and instrumentation used).

b. To maintain a therapeutic level

of anticoagulation when the client is
receiving a continuous infusion of
heparin, the aPTT should be 1.5 to 2.5
times the normal value. Some agencies
use 2 different protocols, a high-
intensity protocol such as for acute
coronary syndrome and a low-
intensity protocol such as for venous
thromboembolism prophylaxis, and
the dosages and recommended aPTT
ranges are slightly different for the two
protocols.
c. Activated partial thromboplastin time
therapy should be measured every 4 to
6 hours during initial continuous
infusion therapy or until the client has
been therapeutic for a specified time
frame and then daily per agency
policy.

d. If the aPTT is too long, per

agency procedure, the dosage should
be lowered.

e. If the aPTT is too short, per

agency procedure, the dosage should
be increased.
3. Interventions
a. Monitor aPTT.
b. Monitor platelet count.
c. Observe for bleeding gums, bruises,
nosebleeds, hematuria, hematemesis,
occult blood in the stool, and
petechiae.
d. Instruct the client regarding measures

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