Practice Problems for Calculating Therapeutic Ranges of Anticoagulant Therapy

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Practice Problems for Calculating Therapeutic Ranges of Anticoagulant Therapy

1. A patient is admitted for management of a deep vein thrombosis and has a prescription for 5,000 units Heparin IVP (bolus), followed by a continuous Heparin infusion 25,000 units/250 ml 0.9% normal saline.  Baseline coagulation studies are reported to be: PT 11 sec; aPTT 25 seconds (control) before the Heparin is begun.

Calculate the therapeutic range using the baseline lab value appropriate for Heparin based on 1.5 times to 2.5 times the control range.

Minimum therapeutic value ______  Maximum therapeutic value___________

1. A client has been on Coumadin for 3 days with the target goal of 1.5 to 2 times client’s control.  The client’s PT control prior to the start of Coumadin was 11 sec. Coagulation studies are drawn by the lab to check whether the client’s Coumadin therapy has resulted in a therapeutic level. When reviewing the labs, the nurse would know that the dose is appropriate when the client’s PT level falls between

Minimum therapeutic value ______  Maximum therapeutic value___________

1. A client with a pulmonary embolism is prescribed a STAT IV bolus of 3000 units of Heparin followed by a continuous Heparin infusion of 800 units per hour. The client did not have a control aPTT drawn prior to the administration of anticoagulation therapy, so the nurse uses the textbook normal control values (aPTT 23 to 35) to calculate the target aPTT level.

The PCP orders a specific target goal of 2.5 times the control value. When reviewing the labs, the nurse would know that the dose is appropriate when the client’s aPPT level falls between

Minimum therapeutic value ______  Maximum therapeutic value___________