A patient exhibits signs and symptoms of heparin overdose. The nurse would anticipate administering which of the following?单项选择题
A
Dobutamine
B
Urokinase
C
Protamine sulfate
D
Vitamin K

Question

A patient exhibits signs and symptoms of heparin overdose. The nurse would anticipate administering which of the following?

BlackTom AI · Accepted Answer

Protamine sulfate neutralizes heparin by forming a stable, inactive complex, so it is the appropriate antidote for heparin overdose.

1) Relevant knowledge points and concepts
- Heparin exerts anticoagulant effects by potentiating antithrombin III, inhibiting thrombin (IIa) and factor Xa, which prolongs the activated partial thromboplastin time (aPTT) and increases bleeding risk.
- Protamine sulfate is a strongly basic (positively charged) protein that binds the highly acidic (negatively charged) heparin, neutralizing its anticoagulant activity.
- Other agents listed (dobutamine, urokinase, vitamin K) act by entirely different mechanisms and do not neutralize heparin.

2) Step-by-step reasoning
- Patient shows signs consistent with heparin overdose (e.g., active bleeding, markedly prolonged aPTT).
- The immediate need is to neutralize circulating heparin to stop bleeding.
- Protamine sulfate directly binds and neutralizes heparin; therefore it should be administered.
- Monitor aPTT and clinical bleeding after administration and provide supportive measures (fluids, transfusion) as needed.

3) Dosing calculation example (intermediate steps)
- Usual empiric dosing guideline: 1 mg protamine neutralizes ~100 units of unfractionated heparin administered within the previous 2–3 hours.
- Example: If the patient received 5,000 units of heparin recently, required protamine = 5,000 units ÷ 100 units per mg = 50 mg protamine.
- Administer slowly IV (to reduce adverse effects); many protocols cap a single dose (commonly ~50 mg) and tailor for longer intervals based on heparin half-life.

4) Why the correct answer is correct
- Protamine sulfate directly and rapidly reverses the anticoagulant action of heparin through chemical neutralization, rapidly reducing bleeding risk and normalizing aPTT.

5) Why the other options are incorrect
- Dobutamine: an inotropic beta-1 agonist used for cardiac contractility, not for anticoagulant reversal.
- Urokinase: a thrombolytic that activates plasminogen to dissolve clots—would worsen bleeding, not reverse heparin.
- Vitamin K: reverses warfarin (vitamin K–dependent factor synthesis) but does not neutralize heparin.

6) Conclusion
Protamine sulfate is the correct antidote for heparin overdose; this matches the provided answer, Protamine sulfate.

A patient exhibits signs and symptoms of heparin overdose. The nurse would anticipate administering which of the following?单项选择题

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