---
title: Long-Term Anti-Coagulation Therapy? Monitor 2 things...
description: Patients with atrial fibrillation and deep vein thrombosis will likely be placed on maintenance anticoagulation therapy to reduce/eliminate blood clots.
image: https://go.myhomecarebiz.com/hubfs/anticoagulant.jpg
---

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## Long-Term Anti-Coagulation Therapy? Monitor 2 things...

Long-Term Anti-Coagulation Therapy? Monitor 2 things...

 Posted by Joy Joan E. De Castro, RN, MSN on Dec 12, 2023

# Long-Term Anti-Coagulation Therapy? Monitor 2 things...

Posted by [Joy Joan E. De Castro, RN, MSN](https://go.myhomecarebiz.com/blog/author/joy-joan-e-de-castro-rn-msn) on Dec 12, 2023

Home health care patients with atrial fibrillation, deep vein thrombosis, pulmonary embolism and/or artificial heart valves will likely be placed on maintenance anticoagulation therapy to reduce/eliminate blood clots. 

The home health clinician monitoring anticoagulation therapy should review the following laboratory results for coagulation status as appropriate...

## Monitor Labwork

- prothrombin time/international normalized ratio (PT/INR) (target range for INR in anticoagulant use (e.g. [warfarin](https://en.wikipedia.org/wiki/Warfarin)) is **2 to 3**),
- platelet count (normal = **150,000 to 450,000)**
- activated partial thromboplastin time (aPTT) (therapeutic APTT range is approximately **70 to 120 seconds**),[![home-health-anticoagulation-therapy](https://no-cache.hubspot.com/cta/default/375308/830b2a73-54ab-4ea5-ae9e-c1c4e59d94a6.png)](https://cta-redirect.hubspot.com/cta/redirect/375308/830b2a73-54ab-4ea5-ae9e-c1c4e59d94a6)
- fibrinogen (normal = **150-400 mg/dL**),
- bleeding time (**normal** BT **values** run in the **range** of 2-9 minutes),
- fibrin degradation products (normal = less than 10 mcg/mL),
- vitamin K (normal = **0.2-3.2** ng/mL),
- activated coagulation time (ACT) (**180 to 240** seconds is the usual amount of **time** for blood to **clot** with anticoagulant therapy).
- hematocrit (Hct) (For men, **38.8 to 50** percent. For women, **34.9 to 44.5** percent)
- hemoglobin (Hgb) (For men, **13.5 to 17.5** grams per deciliter. For women, **12.0 to 15.5** grams per deciliter).

 

## Monitor for Signs of Bleeding

- Check stool (guaiac) and urine (Hemastix) for occult blood.
- Monitor vital signs - increase in heart rate accompanied by low blood pressure or subnormal temperature may signal bleeding.
- Assess skin and mucous membranes for signs of excessive bleeding: 
    - excessive bruising
    - pallor
    - epistaxis
    - hemoptysis
    - hematemesis
    - menorrhagia
    - hematuria
    - melena
    - frank rectal bleeding
    - excessive bleeding from wounds or in the mouth

 

## Common Anticoagulants used in Long Term Therapy

Anticoagulants are often called blood thinners, but they don't really thin blood. They work by increasing the time it takes for a blood clot to form. This prevents an existing clot from increasing in size, thereby preventing a heart attack or stroke.

The most commonly prescribed anticoagulants are:

- warfarin (Coumadin and Marevan)
- dabigatran (Pradaxa)
- apixaban (Eliquis)
- rivaroxaban (Xarelto)
- heparin

 

Anticoagulants must be used with caution in patients with GI, renal and/or liver disease, alcoholism, diabetes, hypertension, hyperlipidemia, and in the elderly and premenopausal women as they are at increased risk for developing cholesterol microemboli.

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