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72歲女性因心房顫動服用warfarin,連續記錄INR與出血狀況。請審視趨勢並選出優先判讀與行動。

Trend

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Time	Data
Day 0 (clinic visit)	INR 2.5 (target 2.0-3.0), no bleeding, on warfarin 5 mg dailyINR 2.5（目標 2.0-3.0），無出血，每日服用 warfarin 5 mg
Day 7	INR 4.1, mild gum bleeding when brushing teeth, no other bleedingINR 4.1，刷牙時輕微牙齦出血，無其他出血
Day 10	INR 6.8, frank epistaxis lasting 30 minutes, mild fatigueINR 6.8，明顯鼻出血持續 30 分鐘，輕微疲倦
Day 12 (ED)	INR 9.2, gross hematuria, two episodes of melena, BP 102/64, HR 108INR 9.2，肉眼血尿，兩次黑便，血壓 102/64，心率 108

Q1. Across the four time points, the trend is best described as which of the following?這四個時間點的趨勢最適合描述為下列何者？

Improving改善中 Stable穩定 Deteriorating with major bleeding伴隨重大出血而惡化

Q2. Which of the following is the priority response in the ED on Day 12?第 12 天在急診的優先處置為何？

Continue the current warfarin dose and recheck INR in 24 hours維持目前 warfarin 劑量並於 24 小時後複查 INR Hold warfarin, give vitamin K, prepare 4-factor PCC or FFP, type and screen, and notify the provider暫停 warfarin、給予 vitamin K、準備 4-factor PCC 或 FFP、進行 type and screen，並通知醫療提供者 Switch the client to enoxaparin and discharge home with follow-up next week改用 enoxaparin 並安排下週追蹤後返家 Give a single oral dose of vitamin K only and discharge with usual warfarin僅給予一次口服 vitamin K，並以原本 warfarin 用法返家

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