The Nurse Is Administering the 0900 Dose of Heparin 5,000

Multiple Choice

The nurse is administering the 0900 dose of heparin 5,000 units subcutaneously ordered every 6 hours to a patient with deep vein thrombosis (DVT) .At 0800,the patient's laboratory values show partial thromboplastin time (PTT) and clotting times are four times the normal range.The nurse observes petechiae on the patient's buttocks and back and recognizes these as signs of risk for significant bleeding.The correct nursing actions at this time are below.Select all that apply.

A) Notify the prescriber before giving the medication.
B) Give subcutaneous heparin as ordered.
C) Hold the medication dose at this time.
D) Chart the reason the medication was not given.
E) Assess for other significant signs and symptoms.
F) Record abnormal findings in the patient's health record.