What should the nurse do if a client on anticoagulant medication presents with a blood pressure of 80/52 and a high PT/INR of 4.5?

When a client on anticoagulant medication presents with a significantly low blood pressure of 80/52 mmHg along with a PT/INR of 4.5, it indicates a state of potential hemorrhage or excessive anticoagulation. The elevated INR suggests that the blood is excessively thin, increasing the risk of bleeding. In this scenario, immediate action is critical.

Notifying the healthcare provider is essential because the situation could escalate rapidly; low blood pressure indicates possible shock or significant blood loss, and the high INR signals a serious risk for bleeding complications. The provider must be informed to assess the client further and determine the appropriate interventions, which might include administering reversal agents for the anticoagulant, fluid resuscitation, or even blood products to stabilize the patient's condition.

While monitoring the client for additional symptoms is important, and documenting findings is necessary for ongoing care, these steps should come after alerting the healthcare provider, who can enact appropriate treatment protocols. Administering additional anticoagulants would be contrary to the patient’s safety, as it would further exacerbate the risk of bleeding. Thus, the most critical step in this situation is to quickly notify the healthcare provider for immediate intervention.