A nurse is assessing the therapeutic International Normalized Ratio (INR) range for a patient receiving Warfarin. Which INR range below is therapeutic?

2.0-3.0

4.0-5.0

1.0-2.0

3.0-4.9

Answer and Explanation

The Correct Answer is A

Choice A reason : The therapeutic INR range for a patient on Warfarin, especially for conditions such as atrial fibrillation, venous thromboembolism, and for the prevention of thrombosis in patients with prosthetic heart valves, is typically 2.0-3.0. This range balances the risk of clotting with the risk of bleeding. An INR of 2.0-3.0 means that the blood is taking twice to three times as long as normal blood to clot, which is the desired effect of the medication in preventing harmful clots.

Choice B reason : An INR range of 4.0-5.0 is generally considered too high for most therapeutic purposes and increases the risk of bleeding complications. This range might be appropriate in very specific clinical situations, such as for patients with mechanical heart valves who may require a slightly higher INR, but it is not the standard therapeutic range.

Choice C reason : An INR range of 1.0-2.0 is below the therapeutic range for patients on Warfarin. This range would not provide sufficient anticoagulation and would leave the patient at risk for thrombotic events.

Choice D reason : An INR range of 3.0-4.9 is higher than the standard therapeutic range and could lead to an increased risk of bleeding. While some patients with mechanical heart valves in the mitral position may require an INR up to 3.5, an INR higher than this is usually not necessary and could be dangerous.

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Correct Answer is B

Explanation

Choice A reason : A hemoglobin (Hgb) level of 16 g/dL is within the normal range for adults, which typically falls between 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women. Therefore, this value does not warrant reporting to the provider as it does not indicate an immediate concern.

Choice B reason : A prothrombin time (PT) of 45 seconds is significantly higher than the normal range of 11 to 13.5 seconds for individuals not on anticoagulation therapy. For patients on warfarin, the target PT is usually 1.5 to 2 times the normal value, depending on the indication for therapy. However, a PT of 45 seconds suggests a high risk of bleeding and requires immediate medical attention.

Choice C reason : The activated partial thromboplastin time (aPTT) of 36 seconds is within the normal range of approximately 21 to 35 seconds⁸. This result indicates that the blood's intrinsic clotting pathway is functioning within expected parameters and does not need to be reported.

Choice D reason : A platelet count of 190,000/mm is within the normal range, which is typically 150,000 to 450,000 platelets/mm. This value is not concerning and does not need to be reported to the provider.

A. Set your goal body weight within 25% of your ideal body weight. B. Limit alcohol consumption to two drinks a day for men and one drink a day for women when hypertensive. C. Plan to lower sodium intake to less than 2,300 mg each day. D. Plan to have potassium blood levels checked when taking thiazide diuretics. E. None F. None

Correct Answer is C

Explanation

Choice A reason : Setting a goal body weight within 25% of the ideal body weight can be misleading. The ideal body weight should be determined based on body mass index (BMI), considering the individual's height and weight. A BMI of 18.5 to 24.9 is considered normal.

Choice B reason : This is a general guideline for alcohol consumption, but for individuals with hypertension, it is often recommended to limit alcohol intake even further to help manage blood pressure

Choice C reason : This is a key recommendation for managing hypertension. Reducing sodium intake helps lower blood pressure and is a widely accepted guideline

Choice D reason : Monitoring potassium levels is crucial when taking thiazide diuretics because these medications can decrease potassium levels in the blood, leading to hypokalemia.

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A nurse is assessing the therapeutic International Normalized Ratio (INR) range for a patient receiving Warfarin. Which INR range below is therapeutic?

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