If a patient's aPTT is significantly elevated while on IV heparin, what should the nurse do?

When a patient's activated partial thromboplastin time (aPTT) is significantly elevated while on IV heparin, the appropriate nursing action is to hold the dose and contact the provider. This is crucial because an elevated aPTT indicates that the patient is at an increased risk for bleeding and may need an adjustment in their anticoagulation therapy. By holding the dose, the nurse is preventing further increase in anticoagulation that could lead to hemorrhagic complications.

Contacting the provider is essential for assessing the situation and determining the next steps, which could include adjusting the heparin dose, considering the need for protamine sulfate (the antidote for heparin), or reevaluating the patient's treatment plan. It's important to ensure patient safety by addressing any potential risks associated with elevated aPTT levels immediately.

Other actions, like administering the scheduled dose or increasing the dose, could further complicate the patient's situation and increase the risk of adverse events. Switching to oral anticoagulants without guidance from the provider could also result in inappropriate management of the patient’s anticoagulation needs based on their current condition.