The nurse is reviewing labs on a client receiving IV heparin and notes an INR of 4.6. Which order by the health care provider does the nurse anticipate?

  • an order for vitamin K IM
  • an order for protamine sulfate
  • an order to redraw labs in 6 hours
  • an order to increase the infusion rate
Number 2 is correct.
An INR of 4.6 indicates that the client is at risk for bleeding. Protamine sulfate is the antidote for heparin. Vitamin K is the antidote for warfarin. Redrawing labs in 6 hours is only ordered when INR is therapeutic and no changes to therapy must be made. Increasing the infusion rate greatly increases the risk of bleeding in this client.