Which of the following INR results warrants a call to the prescriber by the nurse for adjustment of the daily warfarin (Coumadin) dosage?
a. Patient with DVT with an INR of 1.8
b. Patient with atrial fibrillation with an INR of 2.6
c. Patient with a pulmonary embolism with an INR of 3
d. Patient with a mechanical heart valve with an INR of 3.5
ANS: A
An INR of 2 to 3 is appropriate for patients with DVT. Because the INR is below the recommended range, the warfarin dosage should be increased, and the nurse must obtain an order from the prescriber.
The recommended range for the INR of a patient with atrial fibrillation is 2 to 3; no action is needed.
The recommended range for the INR of a patient with a pulmonary embolism is 2 to 3; no action is needed.
The recommended range for the INR of a patient with a mechanical heart valve is 3 to 4.5; no action is needed.
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