Question

A patient who is taking warfarin (Coumadin) has just vomited blood. The nurse notifies the provider, who orders lab work revealing a PT of 42 seconds and an INR of 3.5. Which medication does the nurse expect to administer?

Select one:
a. Protamine sulfate
b. Naloxone (Narcan)
c. Phytonadione (vitamin K)
d. Potassium (K+)

Answer 1

Phytonadione (vitamin K) is the expected medication that the nurse would administer in response to a patient who has vomited blood with prolonged PT and elevated INR while on warfarin therapy, as it is an antidote to warfarin overdose.

Step-by-step explanation:

Given the patient's clinical presentation of vomiting blood combined with a prolonged Prothrombin Time (PT) of 42 seconds and an elevated International Normalized Ratio (INR) of 3.5, which indicates a high risk of bleeding due to warfarin (Coumadin) therapy, the nurse would expect to administer phytonadione (vitamin K). Vitamin K is the antidote for warfarin overdose and is important in this scenario to help reduce the effects of the anticoagulant and lower the risk of further bleeding.

Warfarin works by inhibiting the vitamin K-dependent clotting factors in the coagulation pathway. When the INR is excessively elevated, as in this case, it signifies that the blood is too thin and the risk of bleeding is increased. To counteract this, vitamin K is given to help activate clotting factors and normalize the INR. It is essential to monitor the patient closely and retake coagulation studies after administration to ensure an appropriate response.