Question

JC is a 70 year old male patient with a history of atrial fibrillation that is controlled with medication. His medication regimen also includes warfarin (Coumadin). His daughter has taken him to the Coumadin clinic today and has several questions for the nurse.

She asks “I understand why my father takes a medication for his heart rhythm problems but why does he needs a blood thinner?” How will the nurse answer her?

Family Concerns

JC’s daughter also asks about her father’s clotting times. The nurse states that the prothrombin time (PT) is 19 seconds and the INR is 2.8. Are these values therapeutic? If the INR was 3.5 and JC showed signs of hemorrhage what treatment might the nurse expect to see ordered?

Answer 1

Atrial fibrillation result in accumulation of blood inside the heart due to insufficiency of heart to pump out the blood. This can increase the risk for blood clot formation which may dislodge unto arteries and cause stroke. This is why JC is given blood thinners.
The normal range of prothrombin time is 11-13.5 sec and INR is 0.8-1.2

As the patient is Taking blood thinners his prothrombin time and INR is high.

INR of 3.5 indicates a higher risk of bleeding and hemorrhage. The treatment includes reducing the dose for warfarin, administration of fresh frozen plasma, recombinant Factor VIIa and Vitamin k