Couple Questions on Lab Values!

[ReannaRN]

Hi,

I just had a quick lab value question that has been bothering me! In regards to PT/INR, what exactly does INR indicate? Also, what nursing considerations are important regarding a high or low INR value? I know that it represents a standardized value (International Normalized Ratio), it pertains to someone who is anticoagulated on Coumadin, and that value is somewhere in the range of 2-4.

Thanks!

[ckh23, BSN, RN]

Check this out

https://labtestsonline.org/tests/prothrombin-time-and-international-normalized-ratio-ptinr

As for nursing considerations...think about it. What would a patient be at a higher risk for if they have an elevated INR or a lower INR? Knowing that higher INR and PTT's means the patient is more anti coagulated.

[ReannaRN]

Thanks for the reply. I already know that low PT/INR would mean they are less anticoagulated (risk for clot) and high PT/INR would mean more anticoagulated (risk for bleed). I get all that. I guess I'm just confused as to wrapping my head around what INR actually measures or is a measure of. Where PT is prothrombin time which is the time it takes for blood to clot, if INR measures the ratio of PT to a normalized PT then is it just a confirmation of PT? Why have both? Further, if your INR is out of range ( >3.5) then what does that mean? Pt bleeding out or test is invalid? I know this may be too in depth but for some reason this has really bothered me. I just want a down and dirty differentiation between PT and INR in relation to holding Coumadin and nursing interventions.

[paulwalkman]

I'm sure you already know the answer since last year ago but I'll answer anyway. If your patient has an inr of >3.5 hold the medication and call the position immediately. Some docs will allow up to 3.5 but that's on the rare patients and should be in his notes. The patient is at risk for bleeding out; A hemorrhagic stroke or bleeding from colon cancer, etc. On the other hand is the inr is