The nurse is reviewing laboratory data of a client who is receiving warfarin therapy for atrial fibrillation. Today's INR is 5.0. What action should the nurse take?

Question

The nurse is reviewing laboratory data of a client who is receiving warfarin therapy for atrial fibrillation.  Today's INR is 5.0.  What action should the nurse take?

Quizplus · Accepted Answer

A therapeutic INR level is dependent on the reason the client is receiving the warfarin (an anticoagulant). Typically the therapeutic INR range should be 1.5-2 times the normal "control" value (INR of 2-3) for medical reasons such as deep vein thrombosis, atrial fibrillation, or stroke. An INR of 3 to 3.5 is desired for the client with a mechanical heart valve. An INR of 5.0 or higher places the client at risk for bleeding and requires a dosage adjustment of the warfarin or the administration of vitamin K as an antidote. (Option A) The warfarin should not be administered with an INR of 5. The nurse should hold the dose until further instructions have been received by the HCP. (Option B) Fresh, frozen plasma is considered when major bleeding is occurring related to warfarin overdose, but this is typically after the vitamin K has been administered. (Option C) Protamine is the reversal agent for heparin overdoses. Educational objective: The nurse should hold a dose of warfarin for an INR over 4 and notify the HCP. Vitamin K may need to be administered for INRs of 5 or greater.

The Nurse Is Reviewing Laboratory Data of a Client Who