Day 2 Scenario

It’s the next day (Day 2).

Mr. Jameson’s aPTT is now 78 seconds, well within therapeutic range for IV heparin. He complains of mild gum bleeding when brushing teeth, occasional mild epistaxis. Vital signs remain stable, but the patient expresses concern about bleeding side effects.

Updated Provider Orders:

• Continue IV Heparin infusion at current rate
• Recheck CBC and aPTT in 4 hours
• Continue Warfarin, same dose (5 mg)
• Educate patient on bleeding precautions

Potential Nursing Notes:

• Gums bleeding triggered by soft brushing
• No active uncontrolled hemorrhage, mild only
• Patient anxious about “blood thinner side effects”

At 1900 Thomas had a minor slip resulting in bleeding. Immediate interventions included adjusting Heparin dosage due to an elevated aPTT of 90 seconds. Nurses closely monitored Thomas for any further signs of bleeding, stabilizing the immediate situation.