How do you handle a patient on warfarin?
When possible, a single strength warfarin tablet should preferably be prescribed so that doses are multiples of one tablet. Patients should take their warfarin once a day at the same time in the evening, with INR testing in the morning. The INR should be measured daily for the first five days.
What are nursing considerations for warfarin?
Caution patient to avoid IM injections and activities leading to injury. Instruct patient to use a soft toothbrush, not to floss, and to shave with an electric razor during warfarin therapy. Advise patient that venipunctures and injection sites require application of pressure to prevent bleeding or hematoma formation.
What is the most common complication of warfarin therapy?
The most common side effect — bleeding — can be life-threatening. Rare side effects include stroke, gangrene and death. While warfarin can be a lifesaver for patients suffering from atrial fibrillation and other conditions that may cause a fatal blood clot, the drug also has its drawbacks.
How long should a patient be treated with warfarin?
For patients with an unprovoked DVT or PE, treatment with warfarin is recommended for at least 3 months. After 3 months of therapy, evaluate the risk-benefit ratio of long-term treatment for the individual patient. For patients with two episodes of unprovoked DVT or PE, long-term treatment with warfarin is recommended.
Does warfarin affect PT or PTT?
Results Warfarin markedly affected APTT; for each increase of 1.0 in the international normalized ratio, the APTT increased 16 seconds (95% confidence interval, 10-22 seconds).
When should you not give warfarin?
Severe bleeding, including heavier than normal menstrual bleeding. Red or brown urine. Black or bloody stool. Severe headache or stomach pain.
What should I monitor for warfarin?
Prothrombin time (PT) — The clotting test used to measure the effect of warfarin is the prothrombin time (called pro time, or PT). The PT is a laboratory test that measures the time it takes for a clot to form. It is measured in seconds. It is particularly sensitive to the clotting factors affected by warfarin.
How is Warfarin excreted?
Excretion: Warfarin is primarily eliminated as metabolites by glomerular filtration in the kidney (92% via urine).
Does Warfarin affect PT or PTT?
How is warfarin excreted from the body?
Why is there a lack of documentation for patients on warfarin?
There had been no formal teaching to explain how to manage patients on warfarin (beyond dosing and INR). This had led to uncertainty and anxiety amongst new doctors, as revealed by the preliminary interviews. The lack of a clear, easy to understand, management pathway was thought to be a main reason behind poor documentation.
How should warfarin dosing be tailored based on INR goals?
1 Initial warfarin dosing should be tailored based on patient bleed risk, potential… 2 Daily warfarin dose adjustments should be based on current INR measurements and. 3 Table 4 and 5 provide recommendations for warfarin dosing for INR goals of 2-3 and.
How do you fill out a warfarin chart?
The front page of the warfarin chart had ten information sections to be filled out: Patient details: name, hospital number, date of birth, address on discharge, telephone number, GP. Ward, consultant, completed by, bleep no. If aspirin/clopidogrel/dalteparin to continue on discharge, creatinine, thrombophilia screen.
What is the warfarin management algorithm?
The warfarin management algorithm is a simple, cheap and effective educational intervention that helps to reduce errors in the management of patients on warfarin. It can be implemented in any setting, altered appropriately for each Trust and can be easily saved on smartphones.