The nurse is preparing to administer warfarin sodium 10 mg PO to a client whose international normalized ratio (INR) is 5.0. Which intervention should the nurse implement?

Reference Range:

International 1 normalized ratio (INR) [INR: 0.8 to 1.1]

Administer the scheduled dose.

Discontinue the warfarin schedule.

Withhold warfarin for 24 hours

Obtain another INR analysis immediately.

Answer and Explanation

The Correct Answer is C

A) Administer the scheduled dose: Administering the scheduled dose of warfarin when the INR is 5.0 is not appropriate because this INR level is significantly elevated, indicating a high risk of bleeding. Warfarin dosing should be adjusted based on INR levels to prevent complications such as excessive bleeding.
B) Discontinue the warfarin schedule: Completely discontinuing warfarin may not be necessary unless there are additional factors or signs of bleeding. It is essential to take appropriate action based on the INR level, but discontinuation should be guided by further evaluation and healthcare provider recommendations.
C) Withhold warfarin for 24 hours: Withholding the dose of warfarin is the correct action when faced with an elevated INR of 5.0. This intervention is crucial to prevent potential bleeding complications while waiting for further evaluation and guidance from the healthcare provider regarding additional management, such as administration of vitamin K or other reversal agents.

D) Obtain another INR analysis immediately: While obtaining another INR analysis can be helpful in monitoring trends, it is not the immediate priority if the INR is already 5.0. The primary action should be to withhold the dose and consult with the healthcare provider to determine the appropriate next steps for managing the elevated INR and ensuring patient safety.

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Correct Answer is C

Explanation

A. Gout: Aspirin is not typically used for treating gout. Gout is commonly treated with medications like allopurinol or colchicine, and nonsteroidal anti-inflammatory drugs (NSAIDs) are used selectively.
B. Sepsis: Aspirin is not a primary treatment for sepsis. Sepsis is usually treated with antibiotics, fluid resuscitation, and supportive care.
C. Myocardial infarction: Aspirin is beneficial for preventing further myocardial infarctions (heart attacks) in patients with a history of cardiovascular events or at high risk. It works by inhibiting platelet aggregation, thereby reducing the risk of blood clot formation that can lead to heart attacks.
D. Rheumatoid arthritis: Although aspirin can be used for symptomatic relief in rheumatoid arthritis due to its anti-inflammatory properties, it is not the primary treatment. Other medications, such as disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs), are typically used.

A. Alternate the use of each nostril when administering the nasal spray each day. B. Do not lie down within thirty minutes of use of the nasal spray. C. Use an nonsteroidal anti-inflammatory drug (NSAID) PRN to reduce any inflammation that may occur. D. Take an over-the-counter antihistamine with each dally dose of nasal spray.

Correct Answer is A

Explanation

A. Alternate the use of each nostril when administering the nasal spray each day: Alternating nostrils can help reduce local irritation and rhinitis associated with the use of nasal spray medications. This practice allows each nostril to recover and reduces the risk of continuous irritation from the spray.
B. Do not lie down within thirty minutes of use of the nasal spray: While this can help ensure the medication is absorbed properly, it is not specifically aimed at reducing rhinitis. It is more important to manage irritation by alternating nostrils.
C. Use a nonsteroidal anti-inflammatory drug (NSAID) PRN to reduce any inflammation that may occur: NSAIDs might not be suitable for everyone, and using them could mask symptoms or lead to additional side effects. They are not a primary strategy for managing rhinitis caused by nasal spray use.
D. Take an over-the-counter antihistamine with each daily dose of nasal spray: Antihistamines are not typically used to manage rhinitis caused by nasal sprays. Additionally, combining medications should be done cautiously and usually under medical advice.

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The nurse is preparing to administer warfarin sodium 10 mg PO to a client whose international normalized ratio (INR) is 5.0. Which intervention should the nurse implement? Reference Range: International 1 normalized ratio (INR) [INR: 0.8 to 1.1]

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The nurse is preparing to administer warfarin sodium 10 mg PO to a client whose international normalized ratio (INR) is 5.0. Which intervention should the nurse implement?

Reference Range:

International 1 normalized ratio (INR) [INR: 0.8 to 1.1]