# A client receiving unfractionated heparin for deep vein thrombosis has a platelet count drop from 250,000 to 80,000/mm3 on day 6 of therapy. For each group, select all responses that apply.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=620043&lang=en  
> language: en  
> subject: Laboratory Values  
> category: ROR

## Question

A client receiving unfractionated heparin for deep vein thrombosis has a platelet count drop from 250,000 to 80,000/mm3 on day 6 of therapy. For each group, select all responses that apply.

Immediate nursing actions

Stop the heparin infusion

Notify the healthcare provider

Administer the scheduled heparin

Apply warm compresses to the leg

Anticipated collaborative interventions

Initiate a non-heparin anticoagulant

Obtain an HIT antibody test

Administer platelet transfusion

Continue heparin at a reduced dose

## Explanation

A platelet drop >50% from baseline after heparin exposure suggests heparin-induced thrombocytopenia (HIT). The nurse must stop heparin immediately and notify the provider. Warm compresses are not indicated. Collaborative interventions include starting a non-heparin anticoagulant (e.g., argatroban) and sending HIT antibody test. Platelet transfusions are avoided because they may worsen thrombosis; continuing heparin is contraindicated.

## In-depth explanation

Quick answer
A platelet drop >50% from baseline after heparin exposure suggests heparin-induced thrombocytopenia (HIT). The nurse must stop heparin immediately and notify the provider. Warm compresses are not indicated. Collaborative interventions include starting a non-heparin anticoagulant (e.g., argatroban) and sending HIT antibody test. Platelet transfusions are avoided because they may worsen thrombosis; continuing heparin is contraindicated.
Key cues
Use the client-specific assessment findings and timing in the scenario rather than a memorized diagnosis label.
Clinical reasoning
Connect the relevant cues to the safest nursing interpretation and action for this exact care setting.
Why the alternatives do not fit
The distractors are plausible in another context but are unsupported, mistimed, lower priority, or incomplete for the findings presented.
Priority and safety
Address immediate threats first, stay within nursing scope, and reassess the client after the selected intervention.
Takeaway
For heparin-induced thrombocytopenia, select responses that are both clinically supported and appropriate at this point in care.
**Sources**
- FDA Drug Safety Information

## Clinical scenario

A client receiving unfractionated heparin for deep vein thrombosis has a platelet count drop from 250,000 to 80,000/mm3 on day 6 of therapy. For each group, select all responses that apply.

## Key concepts

- **HIT** — Heparin-induced thrombocytopenia, an immune-mediated reaction causing platelet activation and thrombosis.
- **platelet count** — Number of platelets per cubic millimeter; normal 150,000-400,000/mm3.
- **non-heparin anticoagulant** — Alternative anticoagulant such as argatroban or fondaparinux used when heparin is contraindicated.

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