— 藥理與非經腸給藥 · HARD · MCQ —
一位因心房顫動服用 Warfarin 的病人，INR 值達 7.5。護理師應預期何種處置？
A client taking warfarin for atrial fibrillation presents with an INR of 7.5. Which intervention should the nurse anticipate?
- AAdminister Vitamin K✓ 正解給藥維生素K
- BIncrease the warfarin dose to correct the clotting factor imbalance增加華法林劑量以糾正凝血因子不平衡
- CPrepare for a stat CT scan of the brain準備立即進行腦部CT掃描
- DInitiate heparin infusion immediately立即開始肝素輸注
— Explanation · 中文詳解 —
當 INR 數值過高（通常大於 5.0 且無出血症狀或大於 9.0），臨床指引建議暫停 Warfarin 並給予維生素 K 以拮抗藥物作用。此時出血風險極高，需積極干預以矯正凝血功能，而非增加劑量或轉換藥物。
When INR is significantly elevated (typically >5 with no bleeding, or >9), guidelines recommend holding warfarin and administering vitamin K to reverse anticoagulation. The bleeding risk is high and requires active correction of clotting function. Increasing the dose or starting heparin would worsen bleeding risk.
✦ 台美臨床差異
美國常使用口服維生素 K，台灣則多視院內慣例給予口服或靜脈注射，兩地皆極重視 INR 數值監測。