A client taking warfarin reports black, tarry stools. The IN… | MyMerci
Adverse Effects/Contraindications/Interactions PPT
Question

A client taking warfarin reports black, tarry stools. The INR is 5.8. Which action should the nurse take first?

Explanation
Black, tarry stools with a markedly elevated INR suggest possible gastrointestinal bleeding and excessive anticoagulation. The priority is prompt provider notification and preparation for ordered interventions such as holding warfarin or reversal therapy. Giving another dose or delaying follow-up is unsafe.

In-depth explanation

Clinical Judgment
Warfarin plus bleeding signs is a safety alarm, especially with a high INR.

Memory Tip
High INR + melena = report now.

KR vs US
NCLEX expects recognition of bleeding complications before routine teaching.

Clinical scenario

Clinical Practice Guide
Warfarin requires monitoring for bleeding and INR elevation. Black stools, unusual bleeding, or bruising require prompt clinical evaluation.

Caution
Do not independently prescribe vitamin K; anticipate and carry out provider orders.

Key concepts

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For study reference only. Always follow current clinical guidelines and your institution’s protocols.