QLexNursing

📌Once a patient develops HIT (Heparin-Induced Thrombocytopenia), heparin must NEVER be restarted because even tiny re-exposure can trigger a rapid, life-threatening recurrence.

📌When platelet count has recovered to ≥150,000/µL, it is safe to begin transitioning (“bridging”) from argatroban to long-term anticoagulation such as warfarin—BUT only after recovery, because starting warfarin too early can worsen thrombosis and cause limb gangrene.

📌For patients who cannot use warfarin, continuing long-term therapy with a non-heparin anticoagulant (e.g., fondaparinux, DOACs depending on protocol) is also safe and evidence-based.

📌Therefore, option A reflects the only guideline-compliant, safe, long-term anticoagulation strategy in a patient recovering from HIT.

❌ Incorrect Answers Explained Briefly

Resume prophylactic heparin 6 weeks later — INCORRECT

📌Even after months or years, any heparin exposure can trigger rapid-onset HIT, which is extremely dangerous.

📌Heparin is permanently contraindicated in patients with true HIT.

Discontinue all anticoagulation — INCORRECT

📌HIT creates a pro-thrombotic state that remains high for weeks.

📌Stopping anticoagulation prematurely drastically increases risk of DVT, PE, stroke, limb thrombosis.

Use LMWH — INCORRECT

📌Low Molecular Weight Heparin (LMWH) still contains heparin fragments.

📌LMWH can trigger HIT and is absolutely contraindicated.