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Prothrombin Time and International Normalized Ratio

Prothrombin Time and International Normalized Ratio is a topic covered in the Davis's Lab & Diagnostic Tests.

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Synonym/Acronym:
Protime, PT, and INR.

Rationale
To assess and monitor coagulation status related to therapeutic interventions and disorders such as vitamin K deficiency.

Patient Preparation
There are no food, fluid, activity, or medication restrictions unless by medical direction.

Normal Findings
(Method: Clot detection) 10 to 13 sec.

  • International normalized ratio (INR) = 0.9 to 1.1 for patients not receiving anticoagulation therapy.
  • INR = 2 to 3 for patients receiving conventional anticoagulation therapy with warfarin.
  • INR = 2.5 to 3.5 for patients receiving intensive anticoagulation therapy with warfarin.

Critical Findings and Potential Interventions

INR

  • Greater than 5

Prothrombin Time

  • Greater than 27 sec

Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.

Consideration may be given to verification of critical findings before action is taken. Policies vary among facilities and may include requesting immediate recollection and retesting by the laboratory or retesting using a rapid point-of-care testing instrument at the bedside, if available.

Important signs to note relate to bleeding in specific areas of the body and include prolonged bleeding from cuts or gums, hematoma at a puncture site, hemorrhage, blood in the stool, backache or flank pain, dark-colored urine, joint pain, persistent epistaxis, heavy or prolonged menstrual flow, and shock. Monitor vital signs, unusual ecchymosis, occult blood, severe headache, unusual dizziness, and neurological changes until PT is within normal range. Intramuscular (IM) administration of vitamin K, an anticoagulant reversal drug, may be requested by the HCP.

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Citation

Bladh, Mickey Lynn., and Anne M. Van Leeuwen. "Prothrombin Time and International Normalized Ratio." Davis's Lab & Diagnostic Tests, 7th ed., F.A. Davis Company, 2017. Nursing Central, nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425259/5.1/Prothrombin_Time_and_International_Normalized_Ratio.
Bladh ML, Van Leeuwen AM. Prothrombin Time and International Normalized Ratio. Davis's Lab & Diagnostic Tests. 7th ed. F.A. Davis Company; 2017. https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425259/5.1/Prothrombin_Time_and_International_Normalized_Ratio. Accessed August 20, 2019.
Bladh, M. L., & Van Leeuwen, A. M. (2017). Prothrombin Time and International Normalized Ratio. In Davis's Lab & Diagnostic Tests. Available from https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425259/5.1/Prothrombin_Time_and_International_Normalized_Ratio
Bladh ML, Van Leeuwen AM. Prothrombin Time and International Normalized Ratio [Internet]. In: Davis's Lab & Diagnostic Tests. F.A. Davis Company; 2017. [cited 2019 August 20]. Available from: https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425259/5.1/Prothrombin_Time_and_International_Normalized_Ratio.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Prothrombin Time and International Normalized Ratio ID - 425259 A1 - Bladh,Mickey Lynn, AU - Van Leeuwen,Anne M, BT - Davis's Laboratory & Diagnostic Tests UR - https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425259/5.1/Prothrombin_Time_and_International_Normalized_Ratio PB - F.A. Davis Company ET - 7 DB - Nursing Central DP - Unbound Medicine ER -