The nursing instructor is talking about anticoagulant therapy. The instructor explains that when administering warfarin (Coumadin) to a client with deep vein thrombophlebitis, the nurse monitors the PTT, PT , INR, and hematocrit
Which laboratory value would the instructor teach the class that indicate warfarin is at therapeutic levels?
A) Partial thromboplastin time (PTT) 1½ to 2 times the control
B) Prothrombin time (PT) 1½ to 2 times the control
C) International normalized ratio (INR) of 3 to 4
D) Hematocrit of 32%
Ans: B
Feedback: Warfarin is at therapeutic levels when the client's PT is 1½ to 2 times the control. Higher values indicate increased risk of bleeding and hemorrhage, whereas lower values indicate increased risk of blood clot formation. Heparin, not warfarin, prolongs PTT. The INR may also be used to determine if warfarin is at a therapeutic level. An INR of 2 to 3 is considered therapeutic. Hematocrit does not provide information on the effectiveness of warfarin; however, a falling hematocrit in a client taking warfarin may be a sign of hemorrhage.
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