Supratherapeutic INR: INR 5.2 (target 2.0–3.0) without active bleeding — the warfarin held per the protocol, the provider notified with the value, orders received (hold and/or low-dose vitamin K, a repeat INR), the responsible party notified, and the resident placed on bleeding precautions and monitored. Will recheck the INR per order; supports the Section N update. Skilled interpretation, protocol-based holding, and monitoring required — a daily SNF-level need.
Model abnormal 2
Active bleeding on anticoagulation: new melena with mild tachycardia (HR 104) and lightheadedness, on an anticoagulant — concerning for GI bleeding. The anticoagulant held per the parameters, vital signs and orthostatics obtained, SBAR to the provider, orders for labs/type-and-screen and evaluation (and reversal consideration) received, and the responsible party notified; the resident monitored for hemodynamic change. Will reassess; supports the Section N/I update. Skilled recognition and management required. (GI-bleed detail routes to the Gastrointestinal reference.)
