For a postpartum client with a history of pulmonary embolus who is prescribed heparin prophylaxis, which interventions should be included in the plan?

• A. Increase ambulation without monitoring labs.
• B. Monitor aPTT and platelet count.
• C. Administer heparin without monitoring.
• D. Check bilirubin levels.

Answer: (B)

Monitoring how the anticoagulant is working and catching adverse effects is essential when a postpartum patient with a history of PE is on heparin. The aPTT measures the time it takes blood to clot via the intrinsic pathway, helping ensure the level of anticoagulation stays in a therapeutic range to prevent clots without causing excessive bleeding. Checking the platelet count is important because heparin can cause heparin-induced thrombocytopenia, a serious complication that requires stopping heparin if it occurs. Bilirubin isn’t tied to heparin’s effects, so it doesn’t guide this therapy. Simply increasing ambulation without labs or administering heparin without monitoring misses critical safety checks. Monitoring both aPTT and platelets provides a safe, effective approach to managing anticoagulation in this setting.