A client taking warfarin has an INR of 4.8 (therapeutic range 2.0–3.0). The nurse assesses for which priority finding?

SUPRATHERAPEUTIC INR (4.8 vs target 2-3): This represents excessive anticoagulation — significantly increased bleeding risk. ASSESSMENT PRIORITIES: Urine colour (haematuria); stool colour/occult blood (GI bleed); skin for excessive bruising or haematomas; neurological status (headache, confusion, focal deficits = possible intracranial haemorrhage); injection/IV sites for prolonged bleeding; CRITICAL: Any neurological change + supratherapeutic INR = possible intracranial bleed = IMMEDIATE emergency response; NURSING ACTIONS: Do not administer the next warfarin dose; notify RN/provider with INR value; anticipate: hold warfarin; possibly vitamin K administration; possible fresh frozen plasma if active major bleeding; FOLLOW-UP: Repeat INR; dietary review (increased vitamin K intake?); medication interactions (new antibiotics, NSAIDs); PN SCOPE: Assess for bleeding, hold warfarin, notify — do not independently administer vitamin K without order.