— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位心房顫動病人準備服用華法林（Warfarin）。目前 INR 為 4.5。護理師最適當的措施是什麼？
A nurse is preparing to administer warfarin to a client with atrial fibrillation. The client's current INR is 4.5. What is the nurse's most appropriate action?
- AAdminister the dose as scheduled按預定時間給藥
- BAdminister vitamin K subcutaneously皮下注射維生素 K
- CIncrease the dietary intake of leafy greens增加深綠色蔬菜的飲食攝取
- DHold the dose and notify the provider✓ 正解暫停給藥並通知醫師
— Explanation · 中文詳解 —
華法林治療範圍通常在 INR 2.0-3.0 之間（視適應症而定，最高約 3.5）。INR 4.5 表示凝血功能過度延長，出血風險極高。護理師應先暫停給藥，並立即回報醫師，由醫師評估是否需要減量或給予拮抗劑，切勿擅自給予維生素 K。
The therapeutic range for warfarin is generally an INR of 2.0-3.0 (depending on indication, up to about 3.5). An INR of 4.5 indicates excessively prolonged clotting time and a very high risk of bleeding. The nurse should hold the dose first and notify the physician immediately to determine whether a dose reduction or antagonist is needed; vitamin K should never be administered on the nurse's own initiative.
✦ 台美臨床差異
美國護理師常有處方權調整劑量，台灣護理師通常僅能停藥並回報醫師，由醫師調整醫囑。