Heparin is an anticoagulant that helps prevent and treat blood clots. This review is to prepare nursing students for the NCLEX exam.

Heparin is an indirect thrombin inhibitor and enhances the activity of antithrombin III. This substance inactivates the enzymes that play a role in coagulation. Antithrombin III will prevent the activation of thrombin, which will prevent the conversion of fibrinogen to fibrin.

Heparin can be administered via the subcutaneous or intravenous route. It works to affect the intrinsic pathway of coagulation.

Nursing interventions include: monitoring the aPTT (activated partial thromboplastin time), assessing for excessive bleeding and heparin-induced thrombocytopenia, correctly administering injectable forms of Heparin, etc.

Heparin-induced thrombocytopenia (HIT) is where the body makes antibodies because against Heparin because it’s binding to platelet factor 4 (a blood protein). This creates antibodies that will bind to the heparin and PF4 complex, which activates the platelets. Small clots will form (hence new clots or current clots worsen) and the platelet count falls...hence thrombocytopenia. HIT is treated by discontinuing the Heparin and placing the patient on direct thrombin inhibitor medications.

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