Heparin Protocol

Question 1

What are the main indications for heparin?

Answer 1

DVT/PE treatment or prophylaxis, ACS (STEMI/NSTEMI), atrial fibrillation, DIC, dialysis, central line patency.

Question 2

What routes can heparin be administered?

Answer 2

IV (bolus or continuous infusion) and subcutaneous (for prophylaxis).

Question 3

What lab is commonly monitored for IV heparin therapy?

Answer 3

aPTT (goal usually 42.2-60.9 seconds).

Less than 42.2, you increase heparin per protocol

Greater than 60.9 decrease heparin per protocol

Question 4

What lab can be used instead of aPTT to monitor heparin?

Answer 4

Anti-Xa level.

Question 5

What is the normal dosing for heparin DVT prophylaxis?

Answer 5

5,000 units subcutaneously every 8 to 12 hours.

Question 6

What is a typical initial IV bolus dose of heparin for treatment?

Answer 6

60–80 units/kg (max around 5,000 units).

Question 7

What is a typical IV infusion rate for heparin?

Answer 7

12–15 units/kg/hr, adjusted based on aPTT or anti-Xa.

Question 8

What is the antidote for heparin?

Answer 8

Protamine sulfate.

Question 9

What is HIT and why is it important?

Answer 9

Heparin-induced thrombocytopenia, a dangerous drop in platelets with increased clotting risk—monitor platelets regularly.

Question 10

What are key nursing actions when administering IV heparin?

Answer 10

Use a pump, double-check dose, monitor for bleeding, check labs, avoid IM injections.