一位病人因深層靜脈栓塞持續接受肝素輸注。活化部分凝血活酶時間 (aPTT) 結果為 120 秒。護理師的首要行動為何？
A client is receiving a continuous heparin infusion for DVT. The activated partial thromboplastin time (aPTT) results are reported as 120 seconds. What is the nurse's priority action?
- AContinue the infusion as ordered繼續按指示輸注
- BStop the infusion and notify the provider✓ 正解停止輸注並通知醫師
- CDecrease the infusion rate減慢輸注速率
- DAdminister Vitamin K as an antidote給予維生素K作為解毒劑
肝素治療的目標 aPTT 通常為對照值的 1.5-2.5 倍（約 60-80 秒）。本題數值高達 120 秒，顯示出血風險極高，必須立即停止輸注並通知醫師。維生素 K 是 Warfarin 的解毒劑，非 Heparin 的對應藥物（Protamine sulfate 才是），故不應給予 Vitamin K。
The therapeutic aPTT goal for heparin is usually 1.5–2.5 times the control value (approximately 60–80 seconds). A value of 120 seconds, as in this case, indicates an extremely high risk of bleeding, and the infusion must be stopped immediately and the physician notified. Vitamin K is the antidote for warfarin, not for heparin (the antidote for heparin is protamine sulfate); vitamin K should not be administered.
美台皆有嚴格的肝素給藥 protocol，但美國單位常使用電腦化警示系統自動暫停輸注。