A nurse is caring for a client who has cirrhosis and a prothrombin time of 30 seconds (expected PT range: 11–12.5 seconds). Which of the following medications should the nurse plan to administer?

Choice A reason: Cirrhosis impairs vitamin K-dependent clotting factor synthesis, prolonging prothrombin time. Phytonadione (vitamin K) restores these factors, reducing bleeding risk. Administering it addresses the coagulopathy, making this the correct medication for a prolonged PT in cirrhosis. Choice B reason: Warfarin, an anticoagulant, further prolongs prothrombin time by inhibiting vitamin K-dependent factors. In cirrhosis with bleeding risk, warfarin worsens coagulopathy, making this choice contraindicated and incorrect for the client’s condition. Choice C reason: Alteplase, a thrombolytic, dissolves clots and increases bleeding risk, inappropriate for cirrhosis with prolonged PT. It does not address deficient clotting factors, making this choice incorrect and dangerous for a client at risk of hemorrhage. Choice D reason: Heparin, an anticoagulant, prevents clot formation but worsens bleeding in cirrhosis with prolonged PT. It does not correct the underlying coagulopathy from impaired clotting factor synthesis, making this choice incorrect for the client.