護理師準備給予機械性心臟瓣膜病人 Warfarin。哪項實驗室數據需要立即通知醫師？
A nurse is preparing to administer warfarin to a client with a mechanical heart valve. Which laboratory result requires immediate notification of the provider?
- AINR 4.5✓ 正解INR 4.5
- BPTT 35 secondsPTT 35 秒
- CPT 18 secondsPT 18 秒
- DINR 2.8INR 2.8
機械性瓣膜病人的 INR 目標值通常為 2.5-3.5。若 INR 高達 4.5，表示出血風險過高，此時給藥極可能導致嚴重出血。PT 18 秒通常對應適當的抗凝血範圍，PTT 35 秒則為正常凝血功能範圍，皆不需停藥。通知醫師是為了調整劑量或評估停藥，以平衡瓣膜血栓與全身性出血的風險。
The INR target for a patient with a mechanical valve is generally 2.5–3.5. An INR as high as 4.5 indicates an excessive risk of bleeding, and administering another dose at this time may cause serious hemorrhage. A PT of 18 seconds is usually within the appropriate anticoagulation range and a PTT of 35 seconds reflects normal coagulation; neither requires withholding the dose. The physician is notified so that the dose can be adjusted or the medication held, balancing the risks of valve thrombosis and systemic bleeding.
美台臨床皆依據 INR 調整 Warfarin 劑量，但台灣常規檢查較多依賴 PT 秒數比較，美國醫療體系則強制要求以 INR 值為唯一判斷標準。