Re: Coumadin???
Hello,
There are 2 possibilities that I can think of. One is that the MD did not read the lab results or read them incorrectly before ordering the higher dose. It does happen. Another possibility is that the pt has a diagnosis or needs a procedure that requires a higher INR than usual. Even then an INR higher than 4 usually requires a lower dose of Coumadin. I am thinking the MD made a mistake. Maybe someone else has another idea.
I always clarify orders if they seem out of the norm. Most MDs are grateful when their mistakes are caught before thay are carried out. Some do get grumpy and say "why are you bothering me about this". I just say "I was worried about (fill in the blank with adverse effect) and wanted to make sure this is what you wanted". After all, the pt is paying me to worry about these things and ask questions.
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I always risk "the wrath of doc" if I'm not sure/happy about an order. In the long run it's actually ended up earning me more respect in the places I've worked so far.
!!
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