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Author Question: Which of the following INR results warrants a call to the prescriber by the nurse for adjustment of ... (Read 77 times)

burchfield96

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on: Jul 23, 2018
Which of the following INR results warrants a call to the prescriber by the nurse for adjustment of the daily warfarin (Coumadin) dosage?
 
  a. Patient with DVT with an INR of 1.8
  b. Patient with atrial fibrillation with an INR of 2.6
  c. Patient with a pulmonary embolism with an INR of 3
  d. Patient with a mechanical heart valve with an INR of 3.5

Question 2

A patient is brought to the emergency department for accidental warfarin (Coumadin) overdose. The nurse determines that the patient has no apparent signs of bleeding. Which action should the nurse take next?
 
  a. Obtain a stat PTT level.
  b. Administer protamine sulfate.
  c. Type and crossmatch the patient's blood.
  d. Draw a stat blood level for PT and INR.


amynguyen1221

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Reply #1 on: Jul 23, 2018
Answer to Question 1

ANS: A
An INR of 2 to 3 is appropriate for patients with DVT. Because the INR is below the recommended range, the warfarin dosage should be increased, and the nurse must obtain an order from the prescriber.
The recommended range for the INR of a patient with atrial fibrillation is 2 to 3; no action is needed.
The recommended range for the INR of a patient with a pulmonary embolism is 2 to 3; no action is needed.
The recommended range for the INR of a patient with a mechanical heart valve is 3 to 4.5; no action is needed.

Answer to Question 2

ANS: D
The anticoagulant effects of warfarin can be evaluated by obtaining a stat PT and INR. These results can help determine the patient's level of risk for bleeding and whether administration of an antidote is indicated.
A PTT level is indicated for heparin toxicity, not warfarin toxicity.
Protamine sulfate is the antidote for severe heparin overdose.
Type and crossmatch are indicated for the administration of blood, and none of the information indicates that the patient has experienced blood loss.


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burchfield96

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Reply #2 on: Jul 23, 2018
Both answers were spot on, thank you once again


amynguyen1221

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Reply #3 on: Jul 23, 2018
Great! Please up vote :D


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