Elevated PT, but decreased INR?

Nurses General Nursing

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Hi all,

I had a pt. whose PT wa 12.6, but INR was 1.28 (just started warfarin). I am just a student RN, so I must be confused about how this works. Can one be increased while the other is decreased? Or do they normally correlate in the same direction?

Thanks!

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Hi all,

I had a pt. whose PT wa 12.6, but INR was 1.28 (just started warfarin). I am just a student RN, so I must be confused about how this works. Can one be increased while the other is decreased? Or do they normally correlate in the same direction?

Thanks!

i'm not understanding your confusion.

the pt level looks perfectly normal, as does the inr...

http://www.nlm.nih.gov/medlineplus/ency/article/003652.htm

leslie

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Specializes in Trauma Surgical ICU.

It takes a few days for warfarin to raise INR values.

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Specializes in Med Surge, Tele, Oncology, Wound Care.

They usually go up together. INR goes up as does the PT.

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That's my confusion. Why is the PT above normal, but the INR is below 2.0? (Pt. is >60yo and 2d. post surgery)

Although...it's been hard to get a straight answer about PT/INR levels in school. Mostly I keep getting that they are the same thing/go together/just worry about one, etc.

It's probably just my ignorance, but shouldn't they be on the same side of normal?

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Leslie - the norms for this pt. are PT 9.6-11.8 and INR is 2.0-3.0.

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Specializes in Critical Care.
Leslie - the norms for this pt. are PT 9.6-11.8 and INR is 2.0-3.0.

The normal INR for every patient is about 1.0. An INR of 2.0-3.0 is probably his therapeutic range, which means 2.0-3.0 is the goal INR with the use of coumadin, off coumadin it should be 1.0 (unless he has liver Ca, is an alcoholic, etc). His normal prior to surgery might have been 2.0-3.0, but that was probably on coumadin, which is usually held prior to surgery.

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The normal INR for every patient is about 1.0. An INR of 2.0-3.0 is probably his therapeutic range, which means 2.0-3.0 is the goal INR with the use of coumadin, off coumadin it should be 1.0 (unless he has liver Ca, is an alcoholic, etc). His normal prior to surgery might have been 2.0-3.0, but that was probably on coumadin, which is usually held prior to surgery.

Ahhh...ok. I see what happened. I wrote down his therapeutic range instead of the normal range.

Sorry - still getting the hang of this.

Thanks everyone!

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Specializes in LTC.

It takes time to memorize the normal range of lab values. PT/INR should correlate in the same direction. Like for instance if INR is increased, PT is increased also. Because INR is figured out by using different reagents to test the PT of the blood.

I found when I was starting out that the more I educated myself about what the lab values mean.. the easier it was to remember the normal range.

Heres a good website that explains PT/INR values. http://www.clotcare.com/ptinr.aspx

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Also when first starting a pt on warfarin you want their levels to rise slowly to the therapeutic eange like over a course of 6-10 days you don't want to put them up fast because it increasaes their likelyhood of bleeding.

That's what I learned from the pharmasict at his INR clinic

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