HEMATOLOGY

Heparin-Induced Thrombocytopenia (HIT) Age and Sex Related Differences

• Occurs in about 1-5% of patients receiving heparin therapy. • Usually develops within 5-10 days after starting heparin. • Can occur in any age group receiving anticoagulation therapy. • Increased risk in hospitalized, post-operative (post-op), and critically ill patients. • No major sex difference specifically noted in the slides.

Heparin-Induced Thrombocytopenia (HIT) Signs and Symptoms

• Sudden drop in platelet count (thrombocytopenia). • Thrombosis despite low platelets. • Deep Vein Thrombosis (DVT). • Pulmonary Embolism (PE). • Myocardial Infarction (MI). • Stroke. • Leg pain/swelling. • Chest pain and Shortness of Breath (SOB). • Skin necrosis at heparin injection sites. • Can become rapidly life-threatening.

Heparin-Induced Thrombocytopenia (HIT) Laboratory and Diagnostic Criteria

• Platelet count decreases below 150,000. • Platelet count often drops by 50% from baseline. • Develops after exposure to heparin. • Monitor platelet count and Partial Thromboplastin Time (PTT). • Positive Heparin-Induced Thrombocytopenia (HIT) antibody testing (heparin-PF4 antibodies).

Heparin-Induced Thrombocytopenia (HIT) Nursing Interventions

• STOP all heparin immediately. • Do not flush Intravenous (IV) lines with heparin. • Monitor platelet counts closely. • Assess for signs of thrombosis and emboli. • Monitor for chest pain, dyspnea, neuro changes, leg swelling. • Administer alternative anticoagulants as prescribed. • Monitor coagulation studies. • Assess circulation and perfusion.

Heparin-Induced Thrombocytopenia (HIT) Priorities of Care

• Prevent life-threatening thrombosis. • Prevent Pulmonary Embolism (PE), stroke, and Myocardial Infarction (MI). • Rapid recognition and intervention. • Maintain patient safety. • Monitor for bleeding and clotting complications.

Heparin-Induced Thrombocytopenia (HIT) Special Considerations and Teaching Points

• Patient should avoid all future heparin exposure. • Teach signs of bleeding and thrombosis. • Report chest pain, Shortness of Breath (SOB), unilateral leg swelling immediately. • Use bleeding precautions. • Wear medical alert identification if history of Heparin-Induced Thrombocytopenia (HIT).

Heparin-Induced Thrombocytopenia (HIT) Medications

• Argatroban. • Enoxaparin (Lovenox) - low molecular weight heparin. • Protamine sulfate = antidote for heparin.

Iron Deficiency Anemia Age and Sex Related Differences

• Common in women of reproductive age due to menstruation. • Pregnancy and lactation increase risk because of increased iron demands. • Common during growth spurts in children and adolescents. • Elderly patients at risk due to poor nutrition and chronic disease. • Alcoholism increases risk due to poor absorption/nutrition.

Iron Deficiency Anemia Signs and Symptoms

• Fatigue. • Weakness. • Pallor. • Dyspnea on exertion. • Tachycardia. • Dizziness. • Glossitis. • Brittle nails. • Cold intolerance. • Exercise intolerance. • Hypoxia symptoms due to decreased oxygen-carrying capacity.

Iron Deficiency Anemia Laboratory and Diagnostic Criteria

• Decreased Hemoglobin (Hgb). • Decreased Hematocrit (Hct). • Decreased ferritin. • Decreased serum iron. • Microcytic hypochromic Red Blood Cells (RBCs). • Irregular Red Blood Cell (RBC) size and shape. • Complete Blood Count (CBC) abnormalities. • Diagnostic tests may include: Colonoscopy. • Diagnostic tests may include: Esophagogastroduodenoscopy (EGD). • Diagnostic tests may include: H. pylori testing. • Evaluation for Gastrointestinal (GI) bleeding or fibroids.

Iron Deficiency Anemia Nursing Interventions

• Administer iron supplements between meals for best absorption. • Give with vitamin C to improve absorption. • Avoid giving with milk or antacids. • Monitor Complete Blood Count (CBC), ferritin, Hemoglobin (Hgb), and Hematocrit (Hct). • Assess for signs of Gastrointestinal (GI) bleeding. • Encourage iron-rich foods: Red meat. • Encourage iron-rich foods: Green leafy vegetables. • Encourage iron-rich foods: Beans. • Encourage iron-rich foods: Fortified cereals. • Monitor for constipation and Gastrointestinal (GI) upset. • For Intravenous (IV) iron: Give test dose first. • For Intravenous (IV) iron: Monitor for anaphylaxis.

Iron Deficiency Anemia Priorities of Care

• Correct underlying cause of anemia. • Improve oxygenation and tissue perfusion. • Reduce fatigue. • Improve nutritional status. • Monitor response to treatment.

Iron Deficiency Anemia Special Considerations and Teaching Points

• Dark stools are expected with iron therapy. • Liquid iron can stain teeth. • Constipation and Gastrointestinal (GI) upset are common. • Do not crush sustained-release iron. • Keep iron away from children (can be fatal). • Teach importance of medication compliance. • Avoid excess cow's milk in infants.

Iron Deficiency Anemia Medications

• Oral iron supplements. • Intravenous (IV) iron preparations.

Vitamin B12 Deficiency Anemia Age and Sex Related Differences

• More common in older adults. • Associated with autoimmune gastritis. • Risk increased after: Gastric bypass surgery. • Risk increased after: Ileal resection. • Risk increased after: Malabsorption disorders. • Can occur in patients using acid-suppressing medications long-term.

Vitamin B12 Deficiency Anemia Signs and Symptoms

• Fatigue. • Weakness. • Pallor. • Dyspnea. • Glossitis (smooth red tongue). • Paresthesias in hands and feet. • Loss of balance. • Ataxia. • Confusion. • Muscle weakness. • Neurological deficits due to myelin damage.

Vitamin B12 Deficiency Anemia Laboratory and Diagnostic Criteria

• Megaloblastic anemia. • Large fragile Red Blood Cells (RBCs). • Low vitamin B12 levels. • Complete Blood Count (CBC) abnormalities. • Reticulocyte count. • Possible bone marrow biopsy.

Vitamin B12 Deficiency Anemia Nursing Interventions

• Administer B12: Per Os/by mouth (PO). • Administer B12: Intramuscular (IM). • Administer B12: Subcutaneous (SQ). • Administer B12: Intranasal. • Monitor Complete Blood Count (CBC) and B12 levels. • Assess neuro status. • Fall precautions for weakness and paresthesias. • Encourage foods rich in B12: Meat. • Encourage foods rich in B12: Eggs. • Encourage foods rich in B12: Dairy. • Assess swallowing and nutrition status.

Vitamin B12 Deficiency Anemia Priorities of Care

• Correct anemia. • Prevent permanent neurological damage. • Improve oxygenation. • Improve safety and mobility.

Vitamin B12 Deficiency Anemia Special Considerations and Teaching Points

• NEVER administer Intravenous (IV) B12. • Some patients require lifelong therapy. • Teach safety precautions for numbness and gait issues. • Stress medication compliance. • Teach patient to monitor for worsening neuro symptoms.

Vitamin B12 Deficiency Anemia Medications

• Vitamin B12 (Cobalamin). • Folic acid in severe cases.

Folic Acid Deficiency Anemia Age and Sex Related Differences

• Common in alcoholism. • Increased risk during pregnancy. • Pregnant women need higher folate intake. • Associated with neural tube defects in fetus.

Folic Acid Deficiency Anemia Signs and Symptoms

• Fatigue. • Weakness. • Pallor. • Shortness of breath. • Glossitis. • Large Red Blood Cells (RBCs) with short lifespan. • NO neurological symptoms (important difference from B12 deficiency).

Folic Acid Deficiency Anemia Laboratory and Diagnostic Criteria

• Megaloblastic anemia. • Low folate levels. • Complete Blood Count (CBC) abnormalities. • Macrocytic Red Blood Cells (RBCs).

Folic Acid Deficiency Anemia Nursing Interventions

• Administer folic acid supplements. • Encourage dietary folate: Leafy greens. • Encourage dietary folate: Citrus. • Encourage dietary folate: Beans. • Encourage dietary folate: Fortified cereals. • Monitor Complete Blood Count (CBC). • Treat underlying causes such as alcoholism or malabsorption.

Folic Acid Deficiency Anemia Priorities of Care

• Restore folate levels. • Improve Red Blood Cell (RBC) production. • Prevent complications during pregnancy. • Improve nutrition.

Folic Acid Deficiency Anemia Special Considerations and Teaching Points

• Women of childbearing age should take folic acid daily. • Pregnant women require increased folate. • Encourage healthy nutrition. • Avoid excessive alcohol intake.

Folic Acid Deficiency Anemia Medications

• Folic acid supplements.

Sickle Cell Disease Age and Sex Related Differences

• Inherited autosomal recessive disorder. • Present from childhood. • Affects males and females equally. • Higher prevalence in African ancestry populations.

Sickle Cell Disease Signs and Symptoms

• Severe pain crises. • Ischemia. • Jaundice. • Fatigue. • Anemia. • Acute chest syndrome. • Stroke. • Priapism. • Organ damage. • Osteomyelitis. • Retinal damage. • Splenomegaly/fibrosis. • Renal dysfunction. • Gallstones. • Dyspnea. • Fever during infection.

Sickle Cell Disease Laboratory and Diagnostic Criteria

• Hemoglobin S present. • Complete Blood Count (CBC) abnormalities. • Evidence of hemolytic anemia. • Elevated reticulocytes. • Low hemoglobin/hematocrit.

Sickle Cell Disease Nursing Interventions

• Oxygen therapy. • Intravenous (IV) fluids and electrolytes. • Pain management (often opioids immediately). • Blood transfusions. • Monitor respiratory status closely. • Deep Vein Thrombosis (DVT) prophylaxis. • Infection prevention. • Monitor for acute chest syndrome. • Monitor neuro status for stroke symptoms.

Sickle Cell Disease Priorities of Care

• Prevent hypoxia. • Control severe pain. • Prevent dehydration. • Prevent infection. • Monitor for organ damage. • Prevent respiratory failure.

Sickle Cell Disease Special Considerations and Teaching Points

• Avoid dehydration. • Avoid cold exposure. • Avoid high altitudes. • Avoid overexertion. • Avoid stress. • Drink 3-4 L fluids/day. • Seek treatment immediately for fever/infection. • Importance of medication compliance.

Sickle Cell Disease Medications

• Hydroxyurea. • Opioids. • Low-dose aspirin. • Chelation therapy medications. • Blood transfusions.

Thrombocytopenia Age and Sex Related Differences

• Immune Thrombocytopenic Purpura (ITP) more common in females ages 18-40. • Children may develop acute Immune Thrombocytopenic Purpura (ITP) after viral infections.

Thrombocytopenia Signs and Symptoms

• Petechiae. • Purpura. • Ecchymosis. • Bleeding gums. • Epistaxis. • Menorrhagia. • Melena. • Internal bleeding. • Spontaneous Central Nervous System (CNS) / Gastrointestinal (GI) bleeding if severe.

Thrombocytopenia Laboratory and Diagnostic Criteria

• Platelets less than 150,000. • Severe bleeding risk under 20,000. • Spontaneous bleeding risk under 10,000.

Thrombocytopenia Nursing Interventions

• Bleeding precautions. • Avoid Intramuscular (IM) injections. • Soft toothbrush. • Electric razor. • Stool softeners. • Monitor for bleeding. • Assess neuro status. • Monitor platelet count.

Thrombocytopenia Priorities of Care

• Prevent hemorrhage. • Protect patient from injury. • Monitor for internal bleeding. • Maintain safety.

Thrombocytopenia Special Considerations and Teaching Points

• Avoid aspirin and Nonsteroidal Anti-inflammatory Drugs (NSAIDs). • Avoid ginkgo biloba. • Report bleeding immediately. • Prevent falls and trauma.

Thrombocytopenia Medications

• Steroids. • Intravenous Immunoglobulin (IVIG). • Platelet transfusions.

Neutropenia Age and Sex Related Differences

• Can occur in any age group. • Older adults are at higher risk for infection complications. • Common in cancer patients receiving chemotherapy or radiation. • Increased risk in immunocompromised patients. • No major sex differences noted in slides.

Neutropenia Signs and Symptoms

• Fever (often the FIRST sign of infection). • Chills. • Fatigue. • Weakness. • Mouth sores. • Sore throat. • Signs of infection may be minimal because inflammatory response is decreased. • Severe infections and sepsis can develop quickly.

Neutropenia Laboratory and Diagnostic Criteria

• Decreased neutrophil count. • Absolute Neutrophil Count (ANC): Mild: 1,000-1,500/mm³. • Absolute Neutrophil Count (ANC): Moderate: 500-999/mm³. • Absolute Neutrophil Count (ANC): Severe: less than 500/mm³. • Complete Blood Count (CBC) with differential. • Monitor for infection markers.

Neutropenia Nursing Interventions

• Strict hand hygiene. • Neutropenic precautions. • Private room if needed. • Monitor temperature closely. • Assess for signs of infection every shift. • Avoid fresh flowers/plants. • Limit sick visitors. • Use aseptic technique. • Encourage oral care. • Administer growth factor medications as prescribed. • Monitor Complete Blood Count (CBC) and Absolute Neutrophil Count (ANC).

Neutropenia Priorities of Care

• PREVENT infection. • Early detection of sepsis. • Maintain patient safety. • Prevent exposure to pathogens.

Neutropenia Special Considerations and Teaching Points

• Teach proper handwashing. • Avoid crowds and sick people. • Avoid raw foods if ordered. • Report fever immediately. • Avoid rectal thermometers and suppositories. • Importance of medication compliance. • Teach signs of infection: Fever. • Teach signs of infection: Chills. • Teach signs of infection: Sore throat. • Teach signs of infection: Burning urination.

Neutropenia Medications

• Filgrastim (Neupogen). • Pegfilgrastim (Neulasta).

Disseminated Intravascular Coagulation (DIC) Age and Sex Related Differences

• Can occur at any age. • Seen in critically ill patients. • Increased risk with: Sepsis. • Increased risk with: Trauma. • Increased risk with: Cancer. • Increased risk with: Pregnancy complications. • Increased risk with: Shock. • No major sex differences except pregnancy-related Disseminated Intravascular Coagulation (DIC).

Disseminated Intravascular Coagulation (DIC) Signs and Symptoms

• Simultaneous clotting and bleeding. • Petechiae. • Ecchymosis. • Bleeding from Intravenous (IV) sites. • Hematuria. • Gastrointestinal (GI) bleeding. • Respiratory distress. • Chest pain. • Shortness of breath. • Organ ischemia. • Hypotension. • Shock. • Altered Level of Consciousness (LOC). • Signs of Pulmonary Embolism (PE) or thrombosis.

Disseminated Intravascular Coagulation (DIC) Laboratory and Diagnostic Criteria

• VERY high D-dimer. • Low platelets. • Prolonged Prothrombin Time (PT). • Prolonged Activated Partial Thromboplastin Time (aPTT). • Low fibrinogen. • Abnormal coagulation studies. • Evidence of widespread clotting and bleeding.

Disseminated Intravascular Coagulation (DIC) Nursing Interventions

• Treat underlying cause FIRST. • Monitor Vital Signs (VS) continuously. • Assess for active bleeding. • Monitor Intravenous (IV) sites and wounds. • Monitor labs closely. • Apply pressure to bleeding sites. • Use cold compresses if needed. • Administer oxygen. • Raise Head of Bed (HOB). • Monitor neuro status. • Strict Intake and Output (I&O). • Assess for organ damage: Renal. • Assess for organ damage: Hepatic. • Assess for organ damage: Neurological. • Avoid unnecessary invasive procedures.

Disseminated Intravascular Coagulation (DIC) Priorities of Care

• Maintain Airway, Breathing, Circulation (ABCs). • Control bleeding. • Prevent organ failure. • Maintain tissue perfusion. • Treat shock rapidly.

Disseminated Intravascular Coagulation (DIC) Special Considerations and Teaching Points

• Disseminated Intravascular Coagulation (DIC) is a medical emergency. • Do NOT scrub bleeding sites. • Closely monitor for respiratory failure. • Frequent reassessment is critical. • Family education about seriousness of condition.

Disseminated Intravascular Coagulation (DIC) Medications and Treatments

• Fresh Frozen Plasma (FFP). • Platelets. • Packed Red Blood Cells (PRBCs). • Heparin (sometimes depending on cause). • Oxygen therapy. • Intravenous (IV) fluids.

Bone Marrow Biopsy Signs and Purpose

• Used to evaluate bone marrow disorders. • Diagnoses: Leukemia. • Diagnoses: Aplastic anemia. • Diagnoses: Blood cancers. • Diagnoses: Unexplained cytopenias.

Bone Marrow Biopsy Nursing Interventions Before Procedure

• Explain procedure. • Obtain consent. • Assess coagulation status. • Premedicate if ordered.

Bone Marrow Biopsy Nursing Interventions During Procedure

• Position patient properly (usually side-lying or prone). • Provide emotional support. • Monitor pain.

Bone Marrow Biopsy Nursing Interventions After Procedure

• Apply pressure dressing. • Monitor for bleeding. • Assess puncture site. • Monitor Vital Signs (VS). • Keep patient on bedrest if ordered.

Bone Marrow Biopsy Priorities of Care

• Prevent bleeding. • Pain control. • Infection prevention.

Bone Marrow Biopsy Teaching Points

• Mild soreness expected. • Report excessive bleeding or fever. • Keep site clean and dry.

Epoetin Alfa Therapy Purpose

• Stimulates Red Blood Cell (RBC) production. • Used for: Chronic kidney disease. • Used for: Chemotherapy-related anemia. • Used for: Human Immunodeficiency Virus (HIV) patients on Zidovudine. • Used for: Pre-surgery anemia.

Epoetin Alfa Therapy Nursing Interventions

• Monitor Complete Blood Count (CBC) biweekly. • Monitor Blood Pressure (BP) closely. • Administer Subcutaneous (SQ) or Intravenous (IV). • Refrigerate medication. • Do not shake vial. • Protect from bright light.

Epoetin Alfa Therapy Side Effects

• Hypertension. • Bone pain. • Increased risk of Myocardial Infarction (MI).

Epoetin Alfa Therapy Teaching Points

• Keep medication refrigerated. • Single-use vial. • Importance of lab monitoring.

Epoetin Alfa Therapy Medications

• Epoetin alfa.

Blood Transfusions Purpose

• Replace blood volume. • Improve oxygen-carrying capacity. • Replace clotting factors or platelets.

Blood Transfusions Types of Blood Components

• Packed Red Blood Cells (PRBCs). • Platelets. • Fresh Frozen Plasma (FFP). • Whole blood.

Blood Transfusions Nursing Interventions Before Transfusion

• Verify provider order. • Obtain consent. • Check blood type and compatibility with another nurse. • Baseline Vital Signs (VS). • Use Normal Saline (NS) ONLY tubing. • Assess Intravenous (IV) patency.

Blood Transfusions Nursing Interventions During Transfusion

• Stay with patient for first 15 minutes. • Monitor Vital Signs (VS) closely. • Assess for reactions. • Infuse slowly initially. • Stop transfusion immediately if reaction occurs.

Blood Transfusions Nursing Interventions After Transfusion

• Monitor Vital Signs (VS). • Document response. • Dispose of blood properly. • Monitor labs post-transfusion.

Blood Transfusions Priorities of Care

• Prevent transfusion reactions. • Maintain airway and circulation. • Early recognition of complications.

Hemolytic Reaction Signs and Symptoms

• Fever. • Chills. • Low back pain. • Flank pain. • Hypotension. • Tachycardia. • Hemoglobinuria. • Chest tightness. • Dyspnea.

Hemolytic Reaction Nursing Interventions

• STOP transfusion immediately. • Keep Intravenous (IV) open with Normal Saline (NS). • Notify provider and blood bank. • Monitor Vital Signs (VS). • Prepare emergency medications. • Save blood bag/tubing.

Febrile Reaction Signs and Symptoms

• Fever. • Chills. • Headache. • Flushing.

Febrile Reaction Nursing Interventions

• Stop transfusion. • Notify provider. • Administer antipyretics as ordered.

Allergic Reaction Signs and Symptoms

• Itching. • Hives. • Rash. • Wheezing. • Anaphylaxis.

Allergic Reaction Nursing Interventions

• Stop transfusion. • Administer antihistamines. • Monitor airway. • Epinephrine if severe.

Venous Thrombosis (DVT/VTE) Age and Sex Related Differences

• Risk increases with age. • Increased risk during pregnancy. • Increased risk with oral contraceptives. • Common in immobile or post-op patients.

Venous Thrombosis (DVT/VTE) Risk Factors

• Immobility. • Surgery. • Smoking. • Congestive Heart Failure (CHF). • Cancer. • Pregnancy. • Obesity. • Hypercoagulable states.

Venous Thrombosis (DVT/VTE) Signs and Symptoms

• Unilateral leg swelling. • Pain or tenderness. • Warmth. • Redness. • Edema. • Positive signs of Pulmonary Embolism (PE): Shortness of Breath (SOB). • Positive signs of Pulmonary Embolism (PE): Chest pain. • Positive signs of Pulmonary Embolism (PE): Tachycardia.

Venous Thrombosis (DVT/VTE) Laboratory and Diagnostic Criteria

• Elevated D-dimer. • Ultrasound/Doppler studies. • Coagulation studies.

Venous Thrombosis (DVT/VTE) Nursing Interventions

• Anticoagulant therapy. • Monitor Prothrombin Time (PT) / International Normalized Ratio (INR) and Partial Thromboplastin Time (PTT). • Encourage ambulation. • Compression stockings. • Leg elevation. • Monitor for Pulmonary Embolism (PE). • Oxygen if needed.

Venous Thrombosis (DVT/VTE) Priorities of Care

• Prevent Pulmonary Embolism (PE). • Maintain circulation. • Prevent clot extension. • Prevent bleeding from anticoagulants.

Venous Thrombosis (DVT/VTE) Special Considerations and Teaching Points

• Avoid prolonged immobility. • Smoking cessation. • Medication compliance. • Report chest pain / Shortness of Breath (SOB) immediately. • Teach bleeding precautions.

Venous Thrombosis (DVT/VTE) Medications

• Heparin. • Warfarin. • Eliquis (Apixaban). • Xarelto. • Pradaxa. • Enoxaparin (Lovenox).

Platelet and Coagulation Impairments Overview

• Platelet and coagulation impairments occur when the body cannot properly form or regulate blood clots. • This can lead to: Excessive bleeding, Easy bruising, Hemorrhage, Thrombosis (abnormal clot formation). • Hemostasis normally involves: 1. Blood vessel constriction. • Hemostasis normally involves: 2. Platelet plug formation. • Hemostasis normally involves: 3. Coagulation cascade activation. • Hemostasis normally involves: 4. Fibrin clot stabilization. • Hemostasis normally involves: 5. Clot breakdown (fibrinolysis).

Platelet Disorders: Thrombocytopenia Definition

• Platelet count less than 150,000/μL.

Platelet Disorders: Thrombocytopenia Causes

• Decreased Production: Aplastic anemia, Leukemia, Chemotherapy, Radiation, Human Immunodeficiency Virus (HIV) / Cytomegalovirus (CMV) infection. • Increased Destruction/Decreased Survival: Drug-induced thrombocytopenia, Heparin-Induced Thrombocytopenia (HIT), Immune Thrombocytopenic Purpura (ITP), Disseminated Intravascular Coagulation (DIC). • Mechanical Causes: Prosthetic heart valves, Runners, Drummers.

Platelet Disorders: Thrombocytopenia Signs and Symptoms

• Petechiae. • Purpura. • Ecchymosis. • Bleeding gums. • Epistaxis. • Menorrhagia. • Gastrointestinal (GI) bleeding. • Central Nervous System (CNS) bleeding if severe.

Platelet Disorders: Thrombocytopenia Bleeding Risk Levels

• Under 50,000 → bleeding risk increases. • Under 20,000 → petechiae and mucosal bleeding. • Under 10,000 → spontaneous life-threatening bleeding.

Platelet Disorders: Thrombocytopenia Nursing Interventions

• Bleeding precautions. • Soft toothbrush. • Electric razor. • Stool softeners. • Avoid Intramuscular (IM) injections. • Avoid falls/injury. • Monitor platelets and bleeding.

Platelet Function Impairment: Aspirin Action

• Irreversibly blocks Thromboxane A2 (TxA2). • Prevents platelet aggregation.

Platelet Function Impairment: Aspirin Important Points

• Effect lasts for life of platelet. • Stop 10-14 days before surgery.

Platelet Function Impairment: Aspirin Antidote/Treatment

• Platelet transfusion in emergencies.

Platelet Function Impairment: Clopidogrel (Plavix) Action

• Blocks Adenosine Diphosphate (ADP) receptor. • Prevents platelet aggregation.

Platelet Function Impairment: Clopidogrel (Plavix) Antidote/Treatment

• Platelet transfusion if severe bleeding.

Coagulation Impairments: Heparin Action

• Combines with antithrombin III. • Inactivates factors: lla (thrombin), IX, X, XI, XII.

Coagulation Impairments: Heparin Lab Monitored

• Activated Partial Thromboplastin Time (aPTT).