Which popular herb is used for its possible benefit on the immune system?

A. Platelets 74,000/mm: A platelet count of 74,000/mm³ is significantly lower than the normal range (typically 150,000 to 450,000/mm³). This could indicate heparin-induced thrombocytopenia (HIT), a serious adverse effect of heparin therapy where the immune system forms antibodies against heparin bound to platelet factor 4, leading to a decrease in platelets and increased risk of thrombosis. This is a critical finding and should be reported immediately to the provider for further evaluation and potential adjustment of the treatment plan.

B. White blood cell count 8,000/mm³: This is within the normal range (typically 4,000 to 11,000/mm³) and does not indicate an immediate problem related to heparin therapy or pulmonary embolism management.

C. Partial thromboplastin time (PTT) 55 seconds: While slightly elevated, this PTT is within the therapeutic range for a patient receiving IV heparin (typically 1.5 to 2.5 times the normal control value, or about 45 to 70 seconds). This indicates that the heparin is having the desired anticoagulant effect.

D. Hematocrit 45%: This is within the normal range for adults (typically 38-50% for men and 35-45% for women) and does not indicate an immediate concern related to heparin therapy or pulmonary embolism.

A. Use a 22-gauge needle to inject the medication.

This is inappropriate. Subcutaneous injections typically require a smaller gauge needle, usually between 25 to 30 gauge, to minimize tissue damage and discomfort. A 22-gauge needle is too large for subcutaneous injections and is more appropriate for intramuscular injections.

B. Inject the medication into the abdomen above the level of the iliac crest.

This is appropriate. The preferred site for subcutaneous heparin injection is the abdomen, avoiding areas near the umbilicus by at least 2 inches. Injecting above the level of the iliac crest is appropriate as it ensures the medication is administered into the subcutaneous tissue where it can be properly absorbed. The abdomen is chosen due to its ample subcutaneous tissue and relatively few large blood vessels, reducing the risk of bleeding and bruising.

C. Massage the injection site after administration of the medication.

This is inappropriate. Massaging the injection site after administering heparin is not recommended as it can cause bruising and increase the risk of bleeding. Heparin is an anticoagulant, and massaging the site can disrupt the tissue and lead to complications.

D. Use a 1-inch needle to inject the medication.

This is inappropriate. A 1-inch needle is generally used for intramuscular injections, not subcutaneous injections. For subcutaneous injections, a shorter needle (usually 3/8 to 5/8 inch) is sufficient to reach the subcutaneous tissue without penetrating too deeply into muscle tissue.