Question

A nurse is caring for a client receiving warfarin therapy following a mechanical valve replacement. The client had a prothrombin time and International Normalized Ratio (INR) drawn before breakfast. The laboratory report shows the client's INR reading was 4. What is the nurse's first priority

Answer 1

The PT and INR increase as the time it takes for the blood to clot increases. The clinical setting determines the desired INR range. The goal INR range will often be between 2 and 3, however in exceptional situations, different ranges may be used. The INR in a person not taking warfarin would be close to 1.

There is a higher risk of clotting if the INR is below the desired range (i.e., under-anticoagulated). On the other side, there is a higher risk of bleeding if the INR is above the desired range (i.e., over-anticoagulated).

What is warfarin therapy?

The purpose of warfarin medication is to lessen blood's propensity to clot, not to totally prevent it. As a result, when taking warfarin, the blood's capacity to clot must be closely monitored. Based on the results of routine blood tests, the warfarin dosage is changed to keep the clotting time within a target range. These tests can be carried out either in a lab setting or at home with a portable device.

The prothrombin time is a coagulation test used to assess the impact of warfarin (called pro time, or PT). A laboratory test called the PT tracks how long it takes for a clot to develop. Seconds are used to measure it. It is particularly susceptible to how warfarin affects the clotting factors.

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