Pharmacology and the Nursing Process by Linda Lane Lilley: Practice Exam

What is required when transitioning from heparin to warfarin therapy?

1. Immediate discontinuation of heparin

2. Overlap therapy of heparin and warfarin for at least 5 days

3. Use of a higher dose of warfarin initially

4. Protamine sulfate must be administered

The correct answer is: Overlap therapy of heparin and warfarin for at least 5 days

When transitioning from heparin to warfarin therapy, it is important to use an overlap therapy of heparin and warfarin for at least 5 days. This is because warfarin takes several days to reach its full anticoagulation effect, while heparin has an immediate effect. Therefore, abruptly discontinuing heparin and starting warfarin may lead to a period of time where the patient is not sufficiently anticoagulated and at risk for developing clots. Using a higher dose of warfarin or administering protamine sulfate are not necessary or appropriate actions in this scenario.