INR

[sv123]

Hey I have a scenrario question. If an LPN comes to you, who is a RN, and she gives you a lab result for INR of 4.2. What are your nursing considerations and what would you do?

[pmabraham, BSN, RN]

So, as a RN what nursing considerations would you do and why?

[NurseAgatha]

Hello sv123,

Thanks for your post. This question is difficult to answer because the scenario you described is vague. It does not give us any background information about the patient. Such information is necessary in order to properly evaluate this laboratory result, and decide what to do next. For example:

What are the patient's diagnoses?

Is this patient on anticoagulant therapy?

Did the patient take any medications before the test that could have affected the INR?

Does this patient have any mechanical heart valves? (If so, the desired INR range is between 3.0 to 4.0).

In general, the following are the actions I would probably take, but keep in mind that I do not know anything about this patient:

Observe the patient for s/sx of bleeding (e.g. nosebleeds, hematemesis, purpura, hematuria).

Notify the MD of the lab result and any symptoms that you might observe.

If the patient is scheduled for anticoagulant therapy, I would hold the next dose until you hear back from the MD.

I imagine the MD may order you to give a dose of vitamin K.

Please do tell me more about this patient. :-)

[Double-Helix, BSN, RN]

From your previous posts, it looks like you're a new graduate nurse studying for NCLEX. These questions are excellent opportunities to exercise your critical thinking and do some research. Use your text books, drug and lab references, internet resources, and try to come up with an answer on your own. If you need feedback, let us know what you think and we can help guide you. Simply posting a question for other nurses to answer for you isn't going to be of much benefit to your education.