護理師準備給予病人靜脈注射 heparin，輸注開始前應採取哪些措施？（選所有適合的）
A nurse is preparing to administer an IV infusion of heparin. Which actions are essential before starting the infusion? (Select all that apply.)
- AObtain a baseline activated partial thromboplastin time (aPTT)✓ 正解取得基線活化部分凝血活酶時間（aPTT）
- BUse the client's most recent INR as the primary value for titrating the infusion使用病人最近一次的 INR 作為調整輸注速率的主要依據
- CCheck the client's recent platelet count✓ 正解檢查病人近期的血小板計數
- DMassage the venipuncture site after catheter insertion to prevent bruising導管置入後按摩穿刺部位以預防瘀青
- EVerify the infusion rate with another nurse✓ 正解由另一位護理師核對輸注速率
開始未分段 heparin 輸注前，應取得基線 aPTT、確認近期血小板計數，並依機構的高警訊藥物政策核對輸注速率。這些措施分別建立凝血監測基準、協助辨識血小板低下及後續可能的 heparin 誘發血小板減少症，並預防幫浦設定錯誤。INR 主要監測 warfarin，不能作為 heparin 的主要調整依據；按摩穿刺處則可能加重出血或血腫。
Heparin is a high-alert medication with a narrow therapeutic window. Before starting the infusion, a safety baseline must be established (baseline aPTT) to confirm coagulation status; the platelet count must be checked to rule out the risk of heparin-induced thrombocytopenia (HIT); and a double-check by another nurse must confirm that the infusion rate is correct. This process represents the standard clinical safety procedure for preventing severe bleeding and complications.