The nurse is caring for a client with atrial fibrillation who receives a prescription for warfarin. The international normalized ratio (INR) is 2.8. Which action should the nurse take?

Obtain another blood sample.

Give the next scheduled dose.

Monitor for signs of bleeding.

Notify the healthcare provider.

Answer and Explanation

The Correct Answer is C

A. An INR of 2.8 is within the therapeutic range for clients on warfarin, so obtaining another blood sample is not necessary.
B. An INR of 2.8 indicates that the client is within the therapeutic range, so it is appropriate to give the next scheduled dose. However, monitoring for potential bleeding complications is a higher priority.
C. Monitoring for signs of bleeding is crucial because, while an INR of 2.8 is within the therapeutic range, it is still important to watch for any bleeding complications as part of routine care.
D. Notifying the healthcare provider is not immediately necessary unless there are signs of bleeding or other concerns, as an INR of 2.8 is typically within the acceptable range for therapeutic anticoagulation.

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Correct Answer is A

Explanation

A. Tremors can be a side effect of pregabalin and may indicate a need to adjust the dosage or reconsider the medication; notifying the healthcare provider is appropriate.
B. Administering an antianxiety drug without consulting the healthcare provider may not address the underlying cause of the tremors and could lead to further complications.
C. Orthostatic blood pressure readings are not directly related to the symptom of hand tremors caused by pregabalin.
D. While glucose levels could influence symptoms, tremors are more likely a side effect of pregabalin rather than an indication of altered glucose levels.

A. Administer the medication with a glass of milk. B. Begin tapering the drug dose per protocol. C. Notify the healthcare provider of the finding. D. Teach the client about foods high in calcium.

Correct Answer is C

Explanation

A. Administering the medication with milk will not address the critical issue of the severely low calcium level.
B. Tapering the medication dose is not immediately relevant to the calcium level issue and should be based on the overall treatment plan and the healthcare provider’s guidance.
C. A serum calcium level of 5.5 mg/dL is significantly below the normal range and requires prompt medical evaluation. Notifying the healthcare provider is crucial for addressing the potential causes and necessary interventions.
D. Teaching about calcium-rich foods is important for long-term management but does not address the immediate concern of the critically low calcium level that needs urgent attention.

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The nurse is caring for a client with atrial fibrillation who receives a prescription for warfarin. The international normalized ratio (INR) is 2.8. Which action should the nurse take?

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