An outpatient comes to the laboratory for a PT. He had been in the hospital 6...

An outpatient comes to the laboratory for a PT. He had been in the hospital 6 weeks earlier for treatment of deep vein thrombosis (DVT).

PT: 14.0 sec
Thromboplastin International Sensitivity Index (ISI): 2
PT reference range: 11-13 sec (for this laboratory)
aPTT: not requested

1. Interpret the coagulation results.
2. What is the patient’s international normalized ratio (INR)?
3. Based on all the data provided, what condition is most likely?
4. Is the patient taking enough oral anticoagulant?
5. What is the risk for this patient?

Solutions

Expert Solution

1. Prothrombin time is a test to measure the time taken for blood clots. Usually, it can be done to know the efficiency of medication in the prevention of blood clots. In this patient, the prothrombin time is elevated.

2. Internalized Normalized Ratio is related to PT which is expressed as a ratio.

INR = (patient prothrombin time / Mean normal prothrombin time)^ISI

Patient PT = 14

MNPT = 12

INR = (14 / 12)² = 1.361

The patient INR Ratio is 1.4

The normal range of INR is 1.1

3. Based on the above data, the INR is too low for the patient because he is under anticoagulant. For a DVT patient, the INR should be maintained between 2 and 3 as the doctor prescribes the medication for the blood thinner.

4. The anticoagulant is not enough for the patient. The dosage should be adjusted to increase the INR level. Additionally, limit the food rich in Vitamin K because it makes the blood to clot more quickly which also shoots the INR.

5. The patient can develop the symptoms of the blood clot such as numbness and tingling in limbs, dizziness, pain, swelling, shortness of breath. The patient is also a risk of bleeding. Complications include venous thrombosis, pulmonary embolism if DVT is not treated properly.

Nightingale answered 2 years ago

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