A client is receiving heparin infusion and the aPTT comes back at 120 seconds (therapeutic range 60-100 seconds for anticoagulation, normal 25-35 seconds). What is the appropriate nursing action?

HEPARIN MONITORING with aPTT:

Therapeutic range: For anticoagulation (treatment of VTE, PE, atrial fibrillation), aPTT target is typically 60-100 seconds (1.5-2.5× normal); this range varies by indication and institution protocol; SUPRATHERAPEUTIC (>100 seconds): Excessive anticoagulation — HIGH BLEEDING RISK.

Nursing actions: Hold or reduce the infusion per heparin protocol; notify RN and/or provider for orders; assess for bleeding (check IV sites, urine color, stool, neurological status, vital signs); anticipate order to repeat aPTT after adjustment; HEPARIN REVERSAL if major bleeding: protamine sulfate (antidote).

Monitoring frequency: aPTT checked every 6 hours until stable in therapeutic range, then every 12-24 hours.

Pn scope: Monitor aPTT results; identify values outside parameters; report to RN; implement protocol-driven adjustments per orders; never independently adjust heparin without an order or protocol.