— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位深層靜脈栓塞病人獲醫囑給予華法林（Warfarin），目前 INR 為 4.5。護理師應採取何種正確行動？
A nurse is preparing to administer warfarin to a client with a history of deep vein thrombosis. The client's INR is 4.5. What is the appropriate nursing action?
- AAdminister the dose as scheduled按預定時間給藥
- BHold the dose and notify the physician✓ 正解暫停給藥並通知醫師
- CIncrease the dosage as ordered依指示增加劑量
- DAdminister Vitamin K immediately立即給予維生素K
— Explanation · 中文詳解 —
正常華法林治療目標 INR 通常在 2.0-3.0 之間（機械瓣膜為 2.5-3.5）。INR 4.5 顯示凝血時間過長，出血風險大幅升高。此時應暫停給藥並通知醫師評估減量或處置，不可貿然給藥或自行給予拮抗劑。
The target warfarin INR is typically 2.0-3.0 (2.5-3.5 for mechanical valves). An INR of 4.5 indicates excessive anticoagulation and significantly elevated bleeding risk. The dose should be held and the physician notified to assess for dose reduction or further action. The nurse should not blindly administer the dose or independently give a reversal agent.
✦ 台美臨床差異
美台在 INR 超標的處理原則一致，皆需暫停並評估。美國護理師常有較大權限在 Protocol 內暫停危險藥物。