The health care provider has prescribed a client sodium warfarin (Coumadin) while he is still receiving intravenous heparin. Which is the nurse's best action?
a. Administer both heparin and warfarin as prescribed.
b. Turn off the heparin before administering the warfarin.
c. Clarify the warfarin order with the nursing supervisor.
d. Hold the warfarin dose until the heparin is discontinued.
A
Although both heparin and warfarin are anticoagulants, they have different mechanisms of action and onsets of action. Because warfarin has such a slow onset, it must be started while the client is still receiving heparin. Once the warfarin is therapeutic, as evidenced by the international normalized ratio (INR), the client's heparin can be safely discontinued. Effects of heparin will be cleared from the client's bloodstream within a few hours.
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