What should you do if a patient's INR is over 4?

When a patient's INR (International Normalized Ratio) exceeds 4, it indicates a significantly increased risk for bleeding, particularly in patients who are on anticoagulant therapy such as Coumadin/Warfarin. Taking immediate action to assess the patient for any signs and symptoms of bleeding is crucial, as this can help identify any potential complications that may arise from elevated INR levels.

Signs of bleeding may include unusual bruising, blood in the urine or stool, prolonged bleeding from cuts, or symptoms of internal bleeding such as dizziness or weakness. Early detection of these symptoms allows for timely intervention, which is essential for patient safety.

While monitoring INR levels is an important aspect of anticoagulation management, continuing to administer Warfarin in the face of a high INR without assessing the patient poses a risk of severe complications, including hemorrhagic crises. Preparing to administer potassium is not relevant in this context, as potassium does not counteract the effects of anticoagulation. Ignoring the reading is not an option, as it could lead to life-threatening situations. Prompt assessment for bleeding is the most appropriate and responsible action in this scenario.