Which nursing observation would indicate that the nurse hold the medication warfarin (Coumadin)?
a. An INR (international normalize ratio) of 1.8
b. An INR of 4.8
c. A partial thromboplastin time (APTT) level of 25 seconds
d. An APTT level of 35 seconds
ANS: B
The INR of 4.8 is too high. The dosage of warfarin is adjusted to maintain an INR between 2 and 3. A level of 4.8 indicates that the patient is at risk for excessive bleeding. An INR of 1.8 is below the therapeutic range and would indicate the need for warfarin. APPT is not used to monitor effectiveness of the dose for warfarin.
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