A patient is having difficulty achieving adequate anticoagulation with prescribed doses of warfarin. The nurse realizes that what might be indicated for this patient?
1. genetic testing to determine if the patient metabolizes warfarin slower
2. use of a different anticoagulant
3. review of the patient's diet
4. analysis of the patient's lifestyle
Correct Answer: 1
One use of genetic testing involves predicting or studying the patient's response to particular medications. Pharmacogenetic testing has shown that 20% of Caucasians metabolize warfarin more slowly and take longer to achieve therapeutic dosing. Genetic testing could help determine why the patient has not achieved successful anticoagulation. There might not be another anticoagulant available for the patient. Reviewing the patient's diet might provide some information regarding dietary reasons for the unsuccessful anticoagulation of the patient. An analysis of the patient's lifestyle will not help determine why the patient has not been achieved successful anticoagulation.
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