The practical nurse reports that a client with deep vein thrombosis was mistakenly given heparin in addition to prescribed warfarin. Which action is the priority?

The practical nurse reports that a client with deep vein thrombosis was mistakenly given heparin in addition to prescribed warfarin. Which action is the priority?

• A. Complete an adverse occurrence report.
• B. Notify the healthcare provider.
• C. Monitor for signs of bleeding.
• D. Obtain blood for coagulation studies.

Answer: (C)

When two anticoagulants are given together, the immediate danger is bleeding. The priority is to monitor for signs of bleeding because catching hemorrhage early can prevent serious harm and guides urgent actions to protect the patient. Look for obvious signs such as unusual bruising, gum or nasal bleeding, blood in urine or stool, or external or internal bleeding, and also watch for changes in vital signs or mental status that might indicate occult bleeding. If bleeding or rapid signs of bleeding appear, the most urgent step is to report and act according to orders to stop or reverse anticoagulation and to stabilize the patient. After safety is addressed, steps like notifying the provider and obtaining coagulation studies become important, but they follow the immediate need to detect and control bleeding.

When two anticoagulants are given together, the immediate danger is bleeding. The priority is to monitor for signs of bleeding because catching hemorrhage early can prevent serious harm and guides urgent actions to protect the patient. Look for obvious signs such as unusual bruising, gum or nasal bleeding, blood in urine or stool, or external or internal bleeding, and also watch for changes in vital signs or mental status that might indicate occult bleeding. If bleeding or rapid signs of bleeding appear, the most urgent step is to report and act according to orders to stop or reverse anticoagulation and to stabilize the patient. After safety is addressed, steps like notifying the provider and obtaining coagulation studies become important, but they follow the immediate need to detect and control bleeding.