A patient who is taking warfarin (Coumadin) has just vomited blood. The nurse notifies the provider, who orders lab work revealing a PT of 42 seconds and an INR of 3.5. The nurse will expect to administer:
a. phytonadione (vitamin K1) 1 mg IV over 1 hour.
b. phytonadione (vitamin K1) 2.5 mg PO.
c. protamine sulfate 20 mg PO.
d. protamine sulfate 20 mg slow IV push.
ANS: A
Vitamin K1 is given for warfarin overdose and may be given IV in an emergency. To reduce the incidence of an anaphylactoid reaction, it should be infused slowly. In a non-emergency situation, it would be appropriate to give vitamin K1 orally. Protamine sulfate is used for heparin overdose.
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