Which of the following might indicate a need to decrease the heparin dose?

A recent surgical procedure can indeed necessitate a decrease in heparin dosage to mitigate the risk of excessive bleeding. After surgery, especially if it involves major procedures or interventions, there is a heightened concern for bleeding complications. Since heparin is an anticoagulant, its primary role is to prevent clot formation during dialysis; however, in the post-operative period, there may already be an increased risk of bleeding due to trauma from the surgery.

Therefore, monitoring the patient closely and potentially adjusting the heparin dosage downward is vital to balance the need for anticoagulation with the risk of hemorrhage. In contrast, factors such as clotting in the extracorporeal circuit, access infection, or poor blood flow through a catheter may prompt a different response, like an increase in heparin or addressing mechanical issues, rather than a decrease.