What is the explanation for the prolonged PT/INR?
and what will be your response to the prolonged PT/INR? Select all that apply.
a. Prepare to administer a STAT dose of protamine sulfate.
b. Hold the warfarin.
c. Monitor C.W. for signs and symptoms of bleeding.
d. Obtain an order for aspirin if needed for pain.
e. Avoid injections as much as possible.
The prolongation is caused by warfarin therapy.
Answers: b, c, e
The warfarin should be held (not only because of the prolonged PT/INR but because of his
bleeding), and you should monitor for S/S of further bleeding. Injections need to be avoided as much
as possible to reduce bleeding. Vitamin K, not protamine sulfate, is the antidote for management of
warfarin toxicity. Aspirin would be contraindicated for C.W. because of its antiplatelet action.
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