The Nurse teaches the patient who is receiving warfarin sodium that

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2024

Explanation

Warfarin is an oral anticoagulant medication that requires careful monitoring to ensure it is effective and safe.
The International Normalized Ratio (INR), which is calculated from the Prothrombin Time (PT), is the gold standard laboratory test for monitoring the therapeutic level of warfarin.
For most clinical indications, such as atrial fibrillation or venous thromboembolism (VTE), the target therapeutic INR range is 2.0 to 3.0.
Patient teaching must emphasize the importance of regular INR checks to guide dosage adjustments.

Option A: The Partial Thromboplastin Time (PTT) or activated PTT (aPTT) is the laboratory test used to monitor the effectiveness of heparin, another type of anticoagulant, not warfarin.
Option B: The specific antidote for reversing the effects of warfarin is Vitamin K (phytonadione).
Option D: Warfarin is an anticoagulant, meaning it interferes with the clotting cascade to prevent the formation of blood clots. It works by inhibiting vitamin K-dependent clotting factors.

Clinical Relevance

Nursing practice connection: Knowing Pharmacology: Anticoagulant Therapy (Warfarin) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Accurate patient education on warfarin is a critical nursing responsibility to ensure patient safety and medication adherence.
Failure to monitor INR or recognize signs of bleeding can lead to life-threatening hemorrhage. Conversely, a subtherapeutic INR increases the risk of dangerous blood clots (thrombosis).
Nurses must teach patients to maintain a consistent dietary intake of Vitamin K, as sudden increases can lower the INR and decreases can raise it, affecting the drug's efficacy.

How to Approach the Question

First, identify the key drug in the question stem: 'warfarin sodium'.
Recall the pharmacological class of warfarin: it is an oral anticoagulant.
Analyze each option based on your knowledge of warfarin:
Option A: Think about lab monitoring. Is PTT for warfarin? No, PTT/aPTT is for heparin. INR/PT is for warfarin. This option is incorrect.
Option B: Think about the antidote. Is protamine sulfate for warfarin? No, protamine sulfate is for heparin. Vitamin K is for warfarin. This option is incorrect.
Option C: Is the INR used to assess warfarin? Yes, this is the standard monitoring test. This option is likely correct.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 p. 79-81

E6 Pharmacology Nursing Lilley 11e Part 2 p. 108-110

E6 Medicine Harrison 22e Part 1 p. 992-994

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