Elevated PT and INR - pg.2 | allnurses

Elevated PT and INR - page 2

My client yesterday had an elevated PT and INR. My instructor chose that as my clients diagnosis. On my paper it wants to know the etiology, S&S, medical and surgical treatments (if applicable if not... Read More

  1. Visit  DeLanaHarvickWannabe profile page
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    Just a thought - does he have impaired liver function?
  2. Visit  Stoogesfan profile page
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    Quote from DeLanaHarvickWannabe
    Just a thought - does he have impaired liver function?
    No, it wasn't anywhere in his medical history or doctor's notes. He does have stage 3 renal disease which would contribute to a longer elimination time.
  3. Visit  Sun0408 profile page
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    Quote from Stoogesfan
    No, it wasn't anywhere in his medical history or doctor's notes. He does have stage 3 renal disease which would contribute to a longer elimination time.
    AKD will lengthen the time it takes for the medication to be excreted, this is one reason dialysis is a reversal for pradaxa. But HD is used for active bleeding, uncontrolled by other interventions You are def on the right tract.
  4. Visit  Stoogesfan profile page
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    Thanks! The last care packet was a lot easier, I'm learning do much tho so it's worth it!
  5. Visit  Esme12 profile page
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    Do you see how you gave us information in little pieces slowly. Important pieces of information that were extremely important.

    Here is how this started......
    My client has a history of Afib and a previous MI. So he was on Pradaxa and a baby aspirin at home.
    This patient actually has an elevated PT/PTT on pradaxa that has stage III renal failure (a big deal with pradaxa) in the hospital for a mass in his lungs to rule out malignancy who has a history of lung ca. These are huge details and very important in your assessment of the patient and their situation.

    It's all about the patient......what does this patient have and need.

    You need to look up Pradaxa and renal failure and elevated PT/PTT, malignancies and common metastatic places of Lung CA.
  6. Visit  GrnTea profile page
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    FWIW: We totally understand how hard it is to put together a big-picture when you have a very imperfect idea of what's important. But this is what nursing is all about-- knowing how to think about it all. This is why NCLEX is so challenging for people who have a problem with seeing the bigger picture and are devoted to memorizing small bits of data.


    Hint: lung ca, renal failure, and elevated coags ~ important.
  7. Visit  Stoogesfan profile page
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    Thanks everyone for the help. I think what was tripping me up what my instructor said no to do specifics for my client, really just like in general what are the etiology, prognosis, medical and surgical treatments and nursing care for the admitting diagnosis: which was elevated pt and inr. I ended up having to give specifics for my client tho cause general elected pt and inr was way too broad.


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