護理師準備給予一位人工心臟瓣膜病人服用 warfarin，病人目前的 INR 值為 4.5。護理師最合適的行動為何？
A nurse is preparing to administer warfarin to a client with a mechanical heart valve. The client's current INR is 4.5. Which action is most appropriate?
- AHold the medication and notify the provider✓ 正解暫停藥物並通知醫師
- BRequest an order for Vitamin K申請維生素K處方
- CAdminister half the prescribed dose給予處方劑量的一半
- DAdminister the medication as scheduled按排程給予藥物
Warfarin 的治療性 INR 範圍通常在 2.0-3.0，對於人工瓣膜病人，目標值可高達 2.5-3.5。當 INR 達到 4.5 時，出血風險顯著增加，護理師應先行暫停給藥，並通知醫師進行劑量調整或評估，不可擅自減量或決定是否使用拮抗劑，必須由醫師判斷後續處置。
The therapeutic INR range for warfarin is generally 2.0-3.0, with a target as high as 2.5-3.5 for clients with mechanical heart valves. When the INR reaches 4.5, the risk of bleeding rises significantly; the nurse should hold the dose and notify the provider for dose adjustment or further evaluation. The nurse should not unilaterally reduce the dose or decide to administer an antagonist; the provider must make that determination.
台美臨床對於抗凝血劑監測與暫停機制一致，皆要求護理師在高 INR 時先行暫停並回報。