I am currently studying for the NCLEX and using the Saunders comprehensive review, i came across this question.......
A client with atrial fibrillation who is receiving maintenance therapy with warfarin sodium (Coumadin) has a prothrombin time (PT) of 30 seconds. The nurse anticipates that which will be prescribed?
Adding a dose of heparin
Increasing the next dose of warfarin sodium
Withholding the next dose of warfarin sodium
Administering the next dose of warfarin sodium
The correct answer is 3, Withholding the next dose of warfarin sodium, and I DO NOT understand the rationale. (T[COLOR=#000000]he normal PT is 9.6 to 11.8 seconds for the adult male and 9.5 to 11.3 seconds for the adult female. The goal of oral anticoagulation with warfarin sodium therapy is to achieve a PT at 1.5 to 2 times the laboratory control value. A PT of 30 seconds places the client at risk for bleeding, so the nurse should anticipate that the client would not receive further doses at this time. If the level is too high, the antidote (vitamin K) may be prescribed. The remaining options would make the client even more prone to bleeding.[/COLOR])
I thought the answer would be administering warfarin (blood thinner)
[COLOR=#000000]SOO..if the PT is HIGH (30 SECONDS) Doesn't that mean it takes a LONG TIME for the blood to clot, meaning that the patient should be receiving a blood THINNER ?
someone please help me understand this PT/INR/blood thin/clot process???