A client diagnosed with a pulmonary embolism is receiving a continuous heparin infusion. Which findings will prompt the nurse to immediately notify the healthcare provider? Select all that apply

A. Red or black tarry stools: This finding indicates gastrointestinal bleeding, a serious complication of heparin therapy. It requires immediate provider notification and likely discontinuation or adjustment of the anticoagulant to prevent further bleeding. B. aPTT of 65 seconds: An aPTT of 65 seconds is within or slightly above the therapeutic range for heparin therapy, which is typically 1.5 to 2.5 times the normal value (approximately 60–80 seconds). This value alone does not warrant immediate concern or provider notification. C. aPTT of 120 seconds: An aPTT this high suggests an excessively anticoagulated state, significantly increasing the risk of spontaneous bleeding. The healthcare provider must be notified immediately to adjust the heparin dosage or pause the infusion. D. Platelet count of 300,000/μL: This is a normal platelet count and does not indicate heparin-induced thrombocytopenia or bleeding risk. There is no need to notify the provider based solely on this value. E. aPTT of 40 seconds: This value is below the therapeutic range, indicating subtherapeutic anticoagulation. The client may be at risk for clot progression or recurrence, and the provider should be alerted to consider increasing the dose.