What to monitor in Coumadin therapy?

Nurses General Nursing

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Is there such thing as Serum Coumadin Level as part of the lab results to monitor when you are in Coumadin therapy? I have been taught during an NCLEX review that PT is the blood work to be monitored for patients on Coumadin? Between the two, which is most important to monitor? PT or SCL?

Specializes in Interventional Radiology.
Is there such thing as Serum Coumadin Level as part of the lab results to monitor when you are in Coumadin therapy? I have been taught during an NCLEX review that PT is the blood work to be monitored for patients on Coumadin? Between the two, which is most important to monitor? PT or SCL?

I guess every lab could be different- but serum refers to blood that has been spun down and has separated to "serum' and plasma and platelets. I have worked at two different hospitals and they both followed INR rather than PT. The INR should be between 2-3 for most pts.

Roy Fokker, BSN, RN

1 Article; 2,011 Posts

Specializes in ER/Trauma.

*scratches head* I don't think I've seen a "Coumadin level" being ordered.

We just check the PT and the INR (and co-relate results with pts. last known intake of coumadin and dose).

cheers,

wowza

283 Posts

I guess every lab could be different- but serum refers to blood that has been spun down and has separated to "serum' and plasma and platelets. I have worked at two different hospitals and they both followed INR rather than PT. The INR should be between 2-3 for most pts.

While you could technically get a coumadin level, it will tell you less than the PT or INR will since that is the actual physiological response of that specific patient- longer clotting times. Coumadin acts on the extrinsic pathway of the coagulation cascade so changes PT while heparin acts on the intrinsic pathway and affects PTT.

INR is used to monitor at most places. The INR is basically the PT but normalized for the different manufacturers.

The recommended INR changes based on what the patient is being anticoagulated for. Sometimes it is 2-3, sometimes 2.5-3.5.

Superlost1984

41 Posts

Wow, thanks guys! I got these terms from a practice test for NCLEX. And I got confused what Serum Coumadin level is. tnx

UM Review RN, ASN, RN

1 Article; 5,163 Posts

Specializes in Utilization Management.

Here's an oldie-but-goodie thread on the topic:

https://allnurses.com/med-savvy/can-someone-please-202454.html

morte, LPN, LVN

7,015 Posts

hmm the only reason i can think of to check for coumadin level....which i had never thought about before.....would be to check for patient compliance.....

Superlost1984

41 Posts

hmm the only reason i can think of to check for coumadin level....which i had never thought about before.....would be to check for patient compliance.....

Thanks for the idea. I think so too. I haven't actually seen any order for SCL either.

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