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The client is at risk of developing surgical site infection post the right below-knee amputation (BKA) as a result of poorly managed diabetes mellitus.
Diabetes is a type of disease that leads to a rise in blood glucose levels. Amputation in the lower extremity of the body is extremely common in an individual with unregulated diabetes. This is because diabetes may result in diabetic neuropathy or peripheral arterial disease (PAD). Narrowing of the arteries in the PAD causes the development of ulcers and infections in the lower limbs, which ultimately causes amputation. Diabetes mellitus reduces the wound healing power and therefore delays the surgical site to recovery. This makes the client prone to surgical site infections.
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Subsequent INR readings are influenced by the dose, method, and initial INR of vitamin K. For intravenous vitamin K doses of 2 mg or more, INR decrease is comparable. FFP preadministration has no effect on INR readings 48 hours or more after vitamin K administration.
What is Abstract of Vitamin K dosing to reverse warfarin based on INR, route of administration, and home warfarin dose in the acute/critical care setting?
- Commonly, vitamin K is used to reverse the anticoagulant effects of warfarin. The ideal vitamin K dosage and delivery method that does not lengthen bridging therapy are still unclear.
- To ascertain the elements affecting the level and pace of vitamin K-induced INR reversal in the acute/critical care setting.
- 400 patients' charts from between February 2008 and November 2010 who got vitamin K to counteract the effects of warfarin were examined. International normalized ratios (INRs), intravenous or oral vitamin K doses, and whether or not fresh frozen plasma (FFP) was administered were among the information gathered. INRs were measured 12, 24, and 48 hours before vitamin K treatment.
- At baseline, 12 hours, 24 hours, and 48 hours, respectively, intravenous vitamin K decreased INR more quickly than oral vitamin K (5.09, 1.91, 1.54, and 1.41 vs. 5.67, 2.90, 2.14, and 1.58). Subsequent INR values were impacted by baseline INR (p 0.001), method of administration (p 0.001), and vitamin K dosage (p 0.001). For intravenous vitamin K doses of 2 mg or more, there was a similar drop in INR. Home warfarin dose had no effect on INR responses to intravenous or oral vitamin K (p = 0.98 and 0.27, respectively). FFP had no effect on INR readings 48 hours later. Although larger vitamin K doses and longer anticoagulation bridge therapy appeared to be related, neither the incidence (p = 0.63) nor the duration (p = 0.61) were statistically significant.
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