Prescribed: Heparin bolus 50 units/kg IV now then begin Heparin drip at 12 units/kg/hour

Available: Heparin 5000 units per mL

Patient weight: 70 kg

How many mL will the nurse administer for the prescribed bolus dose? 0,7

Record your answer to the nearest tenth place. (one decimal place)

A. Erythrocyte count: The red blood cell count reflects oxygen-carrying capacity and anemia but does not indicate platelet destruction or immune-mediated reactions. HIT specifically affects platelets, so monitoring erythrocytes would not detect this complication.

B. Fibrinogen degradation products: Fibrinogen degradation products (FDPs) are elevated in disseminated intravascular coagulation or significant clot breakdown. While they reflect fibrinolytic activity, they are not specific or sensitive for heparin-induced thrombocytopenia.

C. Activated partial thromboplastin time (aPTT): Although aPTT is used to monitor therapeutic anticoagulation during heparin infusion, frequent platelet counts are the most direct laboratory marker for HIT. Monitoring aPTT ensures the patient is within the therapeutic range, but detection of a sudden drop in platelet count is crucial for early recognition of HIT.

D. Prothrombin time (PT): PT evaluates the extrinsic coagulation pathway and is primarily used to monitor warfarin therapy. It is not sensitive to heparin therapy or the development of HIT, which involves immune-mediated platelet activation and thrombocytopenia rather than changes in PT.

A. Provide for delivery of 100% oxygen to the lungs under pressure: PEEP does not specifically deliver 100% oxygen; rather, it maintains alveolar patency at end expiration. Oxygen concentration is set separately on the ventilator.

B. Prevent the fibrotic infiltration of the lung tissue: PEEP does not directly prevent fibrosis. ARDS-related fibrosis is a long-term complication, and PEEP’s role is primarily mechanical, not anti-fibrotic.

C. Apply positive pressure during inhalation to fully inflate the lungs: Positive pressure during inhalation is provided by the tidal volume or inspiratory pressure, not PEEP. PEEP maintains pressure at the end of exhalation, not during inspiration.

D. Prevent alveolar collapse during expiration: PEEP maintains a baseline positive pressure in the lungs at the end of expiration, preventing alveolar collapse (atelectasis). This improves oxygenation, increases functional residual capacity, and reduces ventilator-induced lung injury in ARDS patients.