NCLEX VN 11.3

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ACTIVATED PARTIAL THROMBOPLASTIN TIME APTT

screens for deficiencies and inhibitors of factors except VII & XIII.
most commonly used to mon. hep.
screens for coag. disorders.

NURSING CONSIDERATION
APTT

drw bld smpl 1° prior to next dose.
do not drw frm rm into which hep. is infused.
transport aptt stat
aptt should be btwn 1.5-2.5X normal whn client is rcvng hep. therapy.
initiate bldng precautions if needed.

PT PROTHROMBIN TIME INR

pt= vit k dependent.
produced by liver, necessary for fibrin clot formation. measure amnt of x it takes for clot formation. used to mon. response to warfarin na therapy. screens for dysfunction of extrinsic system due to liver dis. vit k def. or DIC. disseminated IV coag.
pt value within 2 sec is normal.
measures effects of oral anticoag.

PT VALUES

9.6-11.8 sec adult male
9.5-11.3 sec adult female
INR 2-3 for standard warfarin NA.
INR 3-4.5 for high dose warfarin NA

NURSING CONSIDERATION FOR PT

baseline pt shld be det. b4 anticoag. therapy is started.
note collection time on lab form.
apply direct pressure to veni site for 3-5 min.
concurrent warfarin NA ĉ hep therapy can lengthen PT for up to 5° after dosing.
diets high in grn leafy veg. can ↑absorbtion of vit K which can shorten PT.
PT longer than 30 sec. places client at risk for hemorrhage.

CLOTTING TIME

mesures time req. for the interaction of all factors inolved in clotting process.

APTT VALUE

20-36 SEC.

CLOTTING TIME VALUE

8-15min.

NURSING CONSIDERATION CLOTTING TIME

client shld not receive hep therapy for 3° prior to specimen coll. because hep therapy will affect rslts.
prolonged test rslt is due to anticoag, test tube agitation, ↑temp. Δ.

PLATELET COUNT

hemostatic plug formation, clot retraction, coag factor activation.

PLATELET COUNT VALUE

150,000-400,000 cells.

NURSING CONSIDERATION
PLATELET COUNT

MON: veni site for bldng.
high altitudes, chr. cold weather, exercise ↑ PC.
bldng precautions shld be instituted in clients ĉ ↓PC.

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