Warfarin Anticoagulant Nursing Care Plan

Warfarin is the cornerstone of medical therapy in stroke prevention and has been shown to be an effective anticoagulant.

Click here for the Warfarin Care Plan.

It is a double-edged sword in that it prevents stroke but can predispose patients to fatal bleeding if the dosage is too high.

There are a number of conditions that can increase the risk of developing blood clots.

These include an irregular heartbeat or atrial fibrillation, a heart valve replacement, a recent heart attack, or certain surgeries such as a fracture or a hip or a knee replacement.

Warfarin is commonly called a “blood thinner”, but the more correct term for it is an anticoagulant.

The blood needs vitamin K to be able to clot, and warfarin slows the production of vitamin K in the body.

That in turn increases the time it can take for the blood to clot.

It helps the blood to flow freely around the body and reduces the risk of clots forming in the heart or in the blood vessels.

The biggest concern for patients and nurses is to ensure the clotting factor in the blood is maintained at the correct level.

If the dose of warfarin is too high a patient could bleed to death, and if it is too low it may not be able to prevent a clot forming.

Consequently, the international normalized ratio (INR) must be closely and frequently monitored to reduce the risk of bleeding.

The therapeutic INR range for warfarin is relatively narrow—between 2.0 and 3.0.

The object of any Care Plan is to ensure the patient’s needs and issues are clearly detailed and properly met.

As always the starting point is consultation.

There has to be a full discussion about the patient’s past medical history and the medical condition which led to warfarin being prescribed, and this should be recorded by you.

You need to discuss the matter in detail with the patient and find out their level of understanding of the treatment and any concerns they have.

It is important to explain all the side effects which can occur, but also reassure the patient that their blood will be checked regularly to ensure that their warfarin levels are correct.

It is also important to explain that the dosage of warfarin can change frequently and can be affected by taking analgesia and antibiotics.

Some foods, including liver and green leafy vegetables, such as spinach and broccoli, contain large amounts of vitamin K. These foods can interfere with the effect of warfarin if eaten in large amounts.

Cranberry juice can also increase the effects of warfarin, so the patient should avoid drinking it.

There is some evidence to suggest that grapefruit juice can interfere with warfarin and cause a slight increase in the international normalisation ratio. It is therefore best not to drink grapefruit juice if you are taking warfarin.

Person centred care planning focuses on the individual issues, which a patient faces and sets out an agreed plan, which is individual and personal to each patient, to address the issues faced.