Warfarin Bleeding
A 70-year-old client takes warfarin for atrial fibrillation and recently finished a course of an antibiotic. The client reports two days of black tarry stools and easy bruising.
Recognize cues
Vital signs: BP 102/62, HR 108, RR 18, SpO2 97%. INR 7.8, hemoglobin 8.9 g/dL, platelets 190,000. Scattered ecchymoses are noted on both forearms and the stool is guaiac positive.
Which finding requires the most immediate follow-up?
Take action
The provider orders the warfarin held, IV vitamin K, serial hemoglobin levels, and a type and screen.
Which two actions should the nurse take first?
Evaluate outcomes
The next morning: INR 2.4, hemoglobin 9.1 g/dL and stable, no new bruising, stools are brown. Vital signs: BP 118/70, HR 84.
Which finding best indicates the treatment is working?
Ready to answer this case?
Practice the full Warfarin Bleeding case — with answer choices and rationales for every part — in the Pharmacology quiz.
Practice this case