A patient taking warfarin with INR 3.2 should be considered for which action?

A patient taking warfarin with INR 3.2 should be considered for which action?

• A. Dose adjustment due to increased bleeding risk
• B. Stopping warfarin
• C. Increase the dose to reach the target range
• D. No change in dosing

Answer: (A)

When managing patients on warfarin, the goal is to keep the INR within the prescribed therapeutic range, commonly about 2.0 to 3.0 for many conditions. An INR of 3.2 means the blood is clotting more slowly than desired, which raises the risk of bleeding. The best action is to adjust the warfarin dose to bring the INR back toward the target range, typically by reducing the dose or skipping a dose and then rechecking the INR in 24 to 72 hours. Increasing the dose would further elevate the INR and worsen bleeding risk, while not changing the dose would leave the patient over-anticoagulated. Stopping warfarin completely is generally reserved for clinical scenarios with high bleeding risk or other directives, not for a single elevated INR without other concerns. Consider evaluating for contributing factors (drug interactions, dietary vitamin K changes, liver function) and recheck after the adjustment.

When managing patients on warfarin, the goal is to keep the INR within the prescribed therapeutic range, commonly about 2.0 to 3.0 for many conditions. An INR of 3.2 means the blood is clotting more slowly than desired, which raises the risk of bleeding. The best action is to adjust the warfarin dose to bring the INR back toward the target range, typically by reducing the dose or skipping a dose and then rechecking the INR in 24 to 72 hours. Increasing the dose would further elevate the INR and worsen bleeding risk, while not changing the dose would leave the patient over-anticoagulated. Stopping warfarin completely is generally reserved for clinical scenarios with high bleeding risk or other directives, not for a single elevated INR without other concerns. Consider evaluating for contributing factors (drug interactions, dietary vitamin K changes, liver function) and recheck after the adjustment.