— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備給予病人華法林（Warfarin）。病人 INR 值為 4.5。哪項處置最合適？
A nurse is preparing to administer warfarin to a client. The client's INR is 4.5. Which action is most appropriate?
- AAdminister a dose of Vitamin K給予維生素K劑量
- BIncrease the dosage as prescribed依醫囑增加劑量
- CHold the dose and notify the healthcare provider✓ 正解暫停給藥並通知醫療提供者
- DAdminister the warfarin as scheduled按預定時間給予華法林
— Explanation · 中文詳解 —
華法林治療範圍通常為 INR 2.0-3.0（部分機械瓣膜病人為 2.5-3.5）。當數值達到 4.5 時，出血風險顯著增加。護理師應先暫停給藥，並通知醫師評估是否調整劑量，而非自行採取其他措施。維生素 K 通常用於緊急逆轉，而非單純高 INR 的首選。
The therapeutic INR range for warfarin is typically 2.0–3.0 (2.5–3.5 in some patients with mechanical valves). When the value reaches 4.5, the bleeding risk increases significantly. The nurse should first hold the dose and notify the physician to evaluate any dose adjustment, rather than taking other actions independently. Vitamin K is typically used for urgent reversal and is not the first choice for a moderately elevated INR alone.
✦ 台美臨床差異
兩地臨床皆依據病人的 INR 值透過協定或醫師醫囑調整劑量。