What might indicate a need to decrease the heparin dose?

• A. The patient has a fever
• B. The patient is dehydrated
• C. The patient just had surgery yesterday
• D. The patient is hypotensive

Answer: (C)

Bleeding risk drives adjustments to anticoagulation during dialysis. If a patient just had surgery yesterday, the risk of bleeding at the surgical site is higher, so lowering or temporarily holding the heparin dose helps prevent postoperative hemorrhage while still keeping the dialysis circuit from clotting. Fever, dehydration, or low blood pressure aren’t direct indicators to reduce heparin in this context; they relate to other aspects of care or different concerns, whereas recent surgery specifically raises the concern for bleeding.