Heparin on the NCLEX
Heparin for NCLEX: aPTT, protamine antidote, HIT, SQ vs IV, LMWH differences.
Heparin potentiates antithrombin III. IV for inpatient anticoagulation; SQ for DVT prophylaxis. The NCLEX tests aPTT range, antidote, and HIT recognition.
Action and use
Activates antithrombin → inhibits thrombin and factor Xa. IV for ACS, PE, DVT treatment. SQ for prophylaxis.
Monitoring
aPTT 60-80 seconds therapeutic (1.5-2x control). Adjust drip per protocol. SQ prophylaxis doesn't require aPTT monitoring.
Antidote
Protamine sulfate. 1 mg per 100 units heparin given in last 4 hours.
HIT (heparin-induced thrombocytopenia)
Type II HIT: platelets drop >50% from baseline, 5-14 days after starting. Paradoxical thrombosis risk. Discontinue all heparin immediately (including flushes). Switch to argatroban or bivalirudin.
LMWH (enoxaparin)
Longer half-life. SQ dosing. Doesn't require aPTT. Antidote partial, protamine reverses ~60%.
Frequently asked
Where do I give SQ heparin?
Abdomen, 2 inches from umbilicus. Don't aspirate. Don't massage.
Drop in platelets on heparin, HIT?
Drop >50% from baseline 5-14 days in. Stop all heparin. Hematology consult.
Quick check
Loading a question…
How ready are you right now?
10 real NCLEX questions, free, in your browser. See how close you are to ready and which subjects are costing you.
Try 10 questions free