Should nurses reduce/omit heparin use for patients on their period? I have a patient who clots fairly easily overall, thus her heparin bolus/maintenance is adjusted accordingly. However, this past week she left a fair amount of blood on her chair due to her period.

What is the protocol regarding heparin use for this situation? I know we've run patients heparin-free pre and post surgery, as well as times of recent bloody nose episodes

JoFel, I would hold the heparin. The menstrual cycle can be viewed the same way as epistaxis; heparin will exacerbate the condition. You can also consult your charge nurse or MD on direction. If the pt normally gets a large bolus perhaps just cutting the dosage will suffice. I also know from experience that heparin during a woman's cycle can prolong the duration of menstruation.

Hope this helps.