A 67-year-old man with atrial fibrillation has been taking warfarin for 18 months. He presents to the emergency department with severe epistaxis, hemoptysis, and a 2-day history of hematuria. Vital signs show BP 92/58, HR 118, RR 22. Laboratory studies reveal INR 8.5 (therapeutic range 2.0-3.0) and hemoglobin 7.2 g/dL (baseline 12.1 g/dL). The patient states he has not missed any doses and denies taking any new medications. Chart review shows no documentation that the patient was counseled about monitoring requirements or potential bleeding complications. Which of the following elements of informed consent was most clearly omitted in this case?
- A)Disclosure of the patient's genetic CYP2C9 and VKORC1 polymorphisms that affect warfarin metabolism
- B)Explanation of the specific target INR range and the importance of regular INR monitoringGABARITO
- C)Discussion of the financial cost of warfarin therapy and availability of generic alternatives
- D)Review of the patient's complete family history for inherited thrombophilia
- E)Detailed discussion of the pathophysiology of atrial fibrillation and thromboembolic risk
Explicação
Valid informed consent requires disclosure of: (1) nature of the proposed treatment, (2) risks and benefits, (3) alternatives, and (4) consequences of non-treatment. For warfarin specifically, a patient must understand that therapeutic efficacy depends critica... Ver explicação completa e trilha adaptativa →