Intravenous heparin therapy is ordered for a patient. While implementing this order, a nurse should ensure the availability of which of the following medications in the nursing unit?

Appeared in: JODHPUR AIIMS SNO-2018

Explanation

Protamine sulphate is the specific antidote for heparin toxicity or overdose.
It functions by binding with heparin to form a stable, inactive complex, thereby neutralizing heparin's anticoagulant effect.
The onset of action is very rapid (within 5 minutes) when administered intravenously, making it essential for emergency situations.
Nursing practice requires that the antidote for any high-alert medication, such as heparin, be readily available on the unit.

Option A: Potassium chloride is an electrolyte supplement used to correct low potassium levels (hypokalemia). It has no effect on blood coagulation or heparin.
Option C: Aminocaproic acid is an antifibrinolytic agent. It prevents the breakdown of blood clots and is used to treat bleeding from hyperfibrinolysis, not to reverse heparin.
Option D: Vitamin K is the specific antidote for the oral anticoagulant warfarin (Coumadin). It works by a different mechanism and is ineffective against heparin.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacology: Antidote for Heparin to guide bedside assessment, documentation, and the next nursing action.
Administering high-alert medications like heparin requires strict safety protocols, including ensuring the antidote is accessible. This is a key nursing responsibility to prevent patient harm.
Nurses must continuously monitor patients on heparin for signs of bleeding, such as hematuria, petechiae, ecchymosis, or bleeding from gums, and be prepared to act quickly.
What if the patient was on warfarin instead of heparin? In that case, the nurse would need to ensure Vitamin K (phytonadione) is available as the reversal agent.

How to Approach the Question

First, identify the key medication mentioned in the question stem: 'heparin therapy'.
Next, understand what the question is asking: which medication should be available while implementing this order. This implies a need for a safety measure or an antidote.
Recall from pharmacology the specific antidote for heparin.
Evaluate the options provided. Systematically eliminate the options that are used for other purposes (e.g., electrolyte replacement, other anticoagulants).
Select the option that is the known, specific antagonist for heparin.

Concept Tested & Keywords

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E6 Pharmacology Nursing Lilley 11e Part 2 pp. 108-110, 123-125

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 p. 79-81

Practise the full JODHPUR AIIMS SNO-2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.