A client is being discharged on warfarin therapy.
What discharge instructions is the nurse required to provide? (Select all that apply.)
Dietary restrictions.
Driving restrictions.
Follow-up laboratory monitoring.
Possible drug-drug interactions.
Reason to take medication.
Wearing a Medic Alert bracelet.
Correct Answer : A,C,D,E,F
Choice A rationale
Warfarin is a vitamin K antagonist that inhibits the synthesis of vitamin K-dependent clotting factors II, VII, IX, and X. Clients must be instructed to maintain a consistent intake of vitamin K-rich foods, such as leafy green vegetables, to avoid fluctuations in warfarin's anticoagulant effect and to maintain a stable INR.
Choice B rationale
Warfarin therapy itself does not impose driving restrictions. The primary concern is the bleeding risk associated with the medication, which would not typically affect a person's ability to drive. Driving is not a discharge instruction required specifically because of the medication itself.
Choice C rationale
Regular laboratory monitoring of the International Normalized Ratio (INR) is essential to ensure the warfarin dosage is therapeutic and safe. The INR normal range is 0.8-1.2. The therapeutic range for warfarin is typically 2.0-3.0 for most indications. Clients need to understand the importance of these appointments.
Choice D rationale
Warfarin is highly protein-bound and metabolized by the cytochrome P450 enzyme system, making it susceptible to numerous drug-drug interactions. Educating the client about potential interactions with other medications, including over-the-counter drugs, is crucial to prevent either bleeding or clotting episodes.
Choice E rationale
A client's adherence to a medication regimen is significantly enhanced when they understand the purpose of the treatment. Explaining that warfarin prevents dangerous blood clots in conditions like atrial fibrillation or deep vein thrombosis helps the client appreciate the importance of consistent daily dosing.
Choice F rationale
Wearing a Medic Alert bracelet is a critical safety measure for clients on warfarin. In an emergency, this bracelet immediately informs healthcare providers that the person is on an anticoagulant, allowing them to make informed decisions about care and to recognize signs of potential bleeding complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
This meal provides carbohydrates and fiber, but it lacks sufficient protein, which is essential for tissue repair and collagen synthesis. Protein intake is crucial for wound healing. A green salad provides vitamins, but the overall meal composition is not optimal for providing the building blocks necessary for skin and tissue regeneration.
Choice B rationale
This dietary choice is excellent for promoting wound healing. Chicken breast provides a high-quality source of protein, which is essential for rebuilding damaged tissue and forming new collagen. Broccoli provides vitamin C, a co-factor in collagen synthesis, while a baked potato offers carbohydrates for energy to fuel the healing process.
Choice C rationale
Vegetable lasagna and green salad provide some vitamins and nutrients, but they are often lower in protein than meat-based options, especially if the lasagna filling is not fortified with high-protein ingredients like cottage cheese. Protein is a critical macronutrient for tissue repair, and the lack of a concentrated source makes this choice suboptimal.
Choice D rationale
This meal is low in essential nutrients. While a hamburger provides some protein, it is often high in saturated fat. The fruit cup and cookie provide simple sugars, which can lead to inflammation and have minimal nutritional value for wound healing. The diet pop offers no nutritional benefit and may contain artificial ingredients that are not beneficial.
Correct Answer is B
Explanation
Choice A rationale
Steak and French fries are high in saturated and trans fats, which raise LDL cholesterol. The dietary management of elevated lipid panels focuses on reducing these fats to decrease cardiovascular risk. Iceberg lettuce offers minimal nutritional value.
Choice B rationale
Baked chicken breast is a lean protein source, and baking avoids adding unhealthy fats. Broccoli and tomatoes are rich in soluble fiber and antioxidants, which can help lower LDL cholesterol and improve overall cardiovascular health. This meal choice is consistent with a heart-healthy diet.
Choice C rationale
Fried catfish is cooked in oil, increasing its saturated fat content. Cornbread often contains high amounts of fat and sugar, contributing to poor lipid profiles. These food choices would not be considered beneficial for managing an elevated lipid panel.
Choice D rationale
Spaghetti with meat sauce often contains high-fat ground meat, contributing to saturated fat intake. Garlic bread is typically prepared with butter or margarine, adding more unhealthy fats. This meal is high in carbohydrates and fats and is not a good choice for managing lipids. .
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