Answer:
Option C, internal bleeding
Explanation:
Heparin is a medication in a class known as anticoagulants, which decrease the clotting ability of platelets in the blood. Because of this, if the patient experiences a trauma, they are at an increased risk for hemorrhage, or blood loss. If the patient is hemorrhaging, the blood pressure will be low, reflecting that there is not much volume within the blood vessels to exert force on the walls of these vessels. For the same reason, the red blood cell (RBC) count will be low.
If the nurse cannot locate the source of the bleed externally, they should suspect that the patient is experiencing internal bleeding, option C.
Why Not Other Choices:
Dehydration could explain the lower blood pressure, as the patient's blood volume will have lowered. But it would not explain the lower RBC count necessarily.
Decreased activated partial thromboplastin time (aPTT) would reflect that clot formation is occurring faster than expected. This does not relate to blood pressure or RBC count, but it does translate to a potential separate issue regarding heparin therapy like disseminated intravascular coagulation (DIC). During heparin therapy, aPTT should be elevated, meaning it takes longer than normal for the blood to form clots.
