Question

A client brought to the emergency department states that he has accidentally been taking two times his prescribed dose of warfarin (Coumadin) for the past week. After noting that the client has no evidence of obvious bleeding, the nurse plans to take which action?

1. Prepare to administer an antidote
2. Draw a sample type and crossmatch and tranfuse the client
3. Draw a sample for an activated partial thromboplastin time (aPTT) level
4. Draw a sample for prothrombin time (PT) and international normalized ratio (INR)

Answer 1

The nurse should draw a sample for prothrombin time (PT) and international normalized ratio (INR) to determine the effects of warfarin overdose and to guide treatment.

Step-by-step explanation:

A client who has accidentally been taking two times the prescribed dose of warfarin should have immediate action taken to mitigate the risk of excessive bleeding despite the absence of obvious bleeding symptoms. Warfarin is an anticoagulant, and overdosing raises the risk of bleeding complications. In this situation, the nurse should draw a sample for prothrombin time (PT) and international normalized ratio (INR). This test will help determine the extent of the overdose by measuring how long it takes for the blood to clot and comparing it to average times. INR is a standardised number that reflects the PT results and is used to adjust warfarin doses to maintain a balance between preventing clots and causing excessive bleeding.