— 藥理與非經腸給藥 · MEDIUM · SATA —
一位心房顫動病人正在服用 warfarin，下列哪些發現需要立即介入？（選所有適合的）
A client is prescribed warfarin for atrial fibrillation. Which findings indicate a need for immediate intervention? (Select all that apply.)
- AINR of 5.5✓ 正解INR 值為 5.5
- BPresence of black, tarry stools✓ 正解出現黑色焦油樣糞便
- CNew onset of epistaxis✓ 正解新發鼻出血
- DConsumption of broccoli and leafy greens食用西蘭花和葉菜類
- EFrequent bruising on the extremities✓ 正解四肢經常出現瘀青
— Explanation · 中文詳解 —
Warfarin 治療窗狹窄，INR 超過 3.0 通常需調整，5.5 屬於危險範圍。黑便提示腸胃道出血，鼻出血（epistaxis）與頻繁瘀青皆是抗凝血過度的徵兆，必須評估出血風險。D 選項不需禁止，只需維持攝取量穩定即可。
An INR of 5.5 indicates excessive anticoagulation and a high risk of bleeding, requiring immediate intervention. Clinical signs such as melena (black, tarry stools), epistaxis, and frequent bruising are also indicators of potential hemorrhage associated with warfarin therapy.
✦ 台美臨床差異
台灣門診病人常因服用中藥或營養補充品影響 INR，需衛教病人告知所有併用藥物。