A student nurse is helping with the care of a client receiving an IV heparin infusion. Which medication should be readily available in case of a heparin overdose?

Choice A rationale Protamine sulfate is the specific antidote for heparin overdose. It is a highly basic (alkaline) protein that forms a stable, inactive complex with the highly acidic heparin molecule, thereby neutralizing its anticoagulant effect, primarily its inhibition of Factor Xa and thrombin. The rapid action of protamine sulfate makes it crucial for reversing life-threatening bleeding associated with excessive heparin administration. Choice B rationale Vitamin K (phytonadione) is the antidote for warfarin overdose because it promotes the synthesis of active Vitamin K-dependent clotting factors (II, VII, IX, X) in the liver, reversing warfarin's inhibitory action. It is ineffective against heparin, which acts on existing clotting factors and antithrombin. Choice C rationale Glucagon is a pancreatic hormone used to treat severe hypoglycemia by stimulating hepatic glycogenolysis and gluconeogenesis, increasing blood glucose levels. It has no chemical or pharmacological effect on reversing the anticoagulant properties of heparin. Choice D rationale Ferrous sulfate is an oral iron supplement used to treat iron deficiency anemia by providing elemental iron necessary for hemoglobin synthesis in red blood cells. It does not interact with or neutralize heparin's anti-clotting mechanism.