PT/INR clarification for new nurse

[ricksy]

New nurse here. Help me think this through. Patient on 7mg Coumadin. INR comes back at 1.58. Therapeutic level is 2-3. So, order will be for INCREASE dose? Or, does the 0.8-1.12 scale take effect here? Confused as to what physican ordered, although I won't go into that here. Just want to hear what normal orders would be. Thank for your help.

[sapphire18]

Yes, they would likely increase the dose.

[nrsang97, BSN, RN]

I agree a likely dosage increase. The INR needs to be 2-3 to be therapeutic for A fib, or PE or DVT.

[TheCommuter, BSN, RN]

Physicians typically want the INR to fall between 2.0 and 3.0 for issues such as DVT prophylaxis, atrial fibrillation, history of PE, or other conditions that cause the blood to pool in one place for a long time. So if the INR is 1.58, you can anticipate that the doc is usually going to increase the dose of Warfarin, but not always.

If the patient has a mechanical heart valve, physicians frequently want the INR to be a tad bit higher (2.5 to 3.5).

[BloomNurseRN, ASN, BSN, RN]

Yes, increasing the dosage makes sense. You want the INR to be 1.5 to 2 times the normal amount while on warfarin to allow for the proper anticoagulation.