Warfarin Wally — Anticoagulation
Warfarin → INR → vitamin K; heparin → aPTT → protamine
Wally thins his blood to stop the next clot — and every day after that is a balancing act between clotting and bleeding, measured in a single number.
Wally's whole story is one table: warfarin is monitored by INR and reversed with vitamin K; heparin is monitored by aPTT and reversed with protamine sulfate. Keep vitamin K intake consistent, not absent, and watch for bleeding everywhere.
Read Warfarin Wally's full story →The story arc
The setup
After a DVT, Wally is bridged from a heparin infusion to warfarin.
The turn
He decides kale is healthy and eats a large salad every day, and his INR drifts to 1.4.
The crisis
After an antibiotic course his INR jumps to 6.8 and he has black tarry stools and gum bleeding.
The save
Warfarin is held, vitamin K given, and Wally learns soft toothbrush, electric razor, no NSAIDs, and to report black stools or unusual bruising.
NCLEX study section — Anticoagulation
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Cardiovascular
Take this chapter into practice questions on the same topic.