The nurse is administering warfarin (Coumadin) to a patient with deep vein thrombophlebitis. Which laboratory value indicates 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 patient's PT is 1½ to 2 times the control. Higher values indicate increased risk of bleeding and hemorrhage; 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 doesn't provide information on the effectiveness of warfarin; however, a falling hematocrit in a patient taking warfarin may be a sign of hemorrhage.
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