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CCHTs practice under defined scope and supervision. Medication administration and dosage titration (including systemic anticoagulation) are nursing responsibilities that require assessment, orders, and documentation. When clotting is suspected, the technician’s role is to recognize signs (darkening venous blood, rising pressures, fibrin in chambers), ensure correct heparin line setup, verify lines are not kinked, and promptly notify the RN. The RN evaluates the patient and circuit, confirms the need for anticoagulation changes, and implements per standing orders or provider directives. Independently adjusting heparin (option B) exceeds scope and jeopardizes patient safety and compliance. Delegating to another tech (C) does not correct the scope issue. Directly obtaining and acting on a medication order (D) without RN involvement is inappropriate. The CCHT supports by stabilizing the circuit (e.g., gentle saline flushes if within policy), documenting findings, and communicating changes. Clear role boundaries protect patients and staff by ensuring assessments and medication decisions are performed by licensed professionals.