Cardiac-Vascular Nursing (CVRN) Practice Exam

If a patient receiving heparin IV shows a significant drop in platelet count, what should the cardiac-vascular nurse do?

1. Request an increase in the medication infusion rate

2. Report that the patient is exhibiting signs of an adverse reaction

3. Request an order for platelet transfusion

4. Report that the medication level is subtherapeutic

The correct answer is: Report that the patient is exhibiting signs of an adverse reaction

When a patient receiving intravenous heparin experiences a significant drop in platelet count, the most appropriate action is to report that the patient is exhibiting signs of an adverse reaction. This situation is indicative of heparin-induced thrombocytopenia (HIT), a serious immune-mediated adverse reaction to heparin that can result in thrombocytopenia, or low platelet counts, which can increase the risk of thrombotic complications. Recognizing and reporting this change in the patient's condition is crucial for timely intervention and management. It allows for the physician to reassess the patient’s treatment plan, including possibly discontinuing heparin and considering alternative anticoagulants. It is important to evaluate any sudden changes in laboratory values, especially when they pertain to medication like heparin, which requires careful monitoring due to its impact on the coagulation system. Understanding the clinical significance of the platelet drop ensures patient safety and appropriate treatment adjustments.