Progressive Care Nursing Certification (PCCN) Practice Exam

What should the nurse anticipate administering to a patient with hematuria secondary to a warfarin overdose and a very high INR?

1. Fresh frozen plasma (FFP)

2. Cryoprecipitate

3. Platelets

4. Vitamin K

The correct answer is: Vitamin K

In the scenario of a patient with hematuria resulting from a warfarin overdose and a significantly elevated INR, the appropriate intervention is to administer Vitamin K. Warfarin functions as an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors, which are essential for normal coagulation. When the INR is high, it indicates that the blood is coagulating too slowly, increasing the risk of bleeding. Administering Vitamin K can directly counteract the effects of warfarin by facilitating the synthesis of clotting factors, hence helping to restore normal coagulation levels. This is particularly important in cases of overdose where rapid reversal is necessary to prevent or control bleeding. While fresh frozen plasma could theoretically be used to replace clotting factors quickly, Vitamin K is more appropriate for long-term management in cases like this. Cryoprecipitate and platelets are not indicated in this situation, as they address different types of coagulation disorders and do not directly counteract the action of warfarin. Thus, the administration of Vitamin K sets the pathway for reversing warfarin’s anticoagulant effects efficiently and addressing the underlying cause of the hematuria.