امرأة عمرها ٨٢ سنة تعيش وحدها، تأخذ وارفارين للرجفان الأذيني، وتأخذ دواء للضغط ومنوماً. سقطت مرتين هذا الشهر في الحمام ليلاً، بدون إصابة كبيرة، والـINR ٢٫٦. أي تدخل تمريضي هو الأنسب؟

An 82-year-old woman living alone takes warfarin for atrial fibrillation plus an antihypertensive and a sleeping tablet. She has fallen twice this month in the bathroom at night without major injury; INR 2.6. Which nursing intervention is most appropriate?

1. Have the nurse stop warfarin until his walking improves
2. Restrain him in bed overnight to prevent further falls
3. Assess fall risk, secure the environment and inform the prescriber
4. Ignore the falls because neither caused any injury

Answer: C) Assess fall risk, secure the environment and inform the prescriber. Falls on anticoagulants raise the risk of intracranial bleeding. The cause is assessed, the environment secured and the prescriber informed to weigh stroke against bleeding risk. Nurses do not stop the drug themselves, and restraints increase injury.