A client taking warfarin (Coumadin) should be instructed to avoid herbal supplements such as green tea, ginkgo, feverfew, garlic, and ginger because these could:

Increase the risk for bleeding

Cause severe headache

Decrease the effects of the warfarin (Coumadin)

Cause severe hypotension

Answer and Explanation

The Correct Answer is A

A. Increase the risk for bleeding: Herbal supplements like green tea, ginkgo, feverfew, garlic, and ginger can potentiate the effects of warfarin by enhancing its anticoagulant properties. This increases the risk of bleeding, as warfarin itself is a blood thinner designed to prevent clot formation. These herbs can further inhibit platelet aggregation or enhance anticoagulation, leading to a higher risk of bleeding complications.

B. Cause severe headache: While some herbal supplements can cause headaches as a side effect, this is not the primary concern when combined with warfarin. The interaction between these herbs and warfarin does not commonly result in severe headaches. The primary issue is the increased risk of bleeding.

C. Decrease the effects of the warfarin (Coumadin): These particular herbal supplements do not generally decrease the effects of warfarin. In fact, they are more likely to increase its anticoagulant effects. Some other substances might interfere with warfarin's efficacy, but the herbs listed are known to enhance its bleeding risk.

D. Cause severe hypotension: Severe hypotension is not a common result of combining these herbal supplements with warfarin. The primary interaction is related to the blood-thinning effects, not to blood pressure regulation. Herbal supplements that might affect blood pressure are not typically those that interact significantly with warfarin in this manner.

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Correct Answer is D

Explanation

A. Food, Drug and Cosmetic Act (FD&C Act): This act sets the groundwork for food and drug regulations, but it's not the specific legislation governing dietary supplements. While FD&C Act applies to some aspects of supplements, DSHEA has more specific regulations.

B. Joint Commission on the Accreditation of Healthcare Organizations (JCAHO): This organization focuses on accrediting healthcare facilities, not regulating supplements.

C. Health and Human Services (HHS): HHS is a broad department encompassing various healthcare agencies, but DSHEA is the specific act within HHS that governs supplements.

D. Dietary Supplement Health and Education Act (DSHEA): This 1994 act specifically addresses dietary supplements, outlining regulations for labeling, manufacturing, and marketing. It places the responsibility for ensuring the safety and effectiveness of supplements on the manufacturers, unlike prescription drugs approved by the FDA.

A. Labeling is not always reliable and herbal products should be used with caution. B. Herbal products are approved under strict FDA regulations. C. There are so few side effects, and they can be purchased without a prescription. D. The manufacturer has repeatedly demonstrated effectiveness.

Correct Answer is A

Explanation

A. Labeling is not always reliable and herbal products should be used with caution. Herbal products are not subject to the same rigorous regulations and testing as pharmaceutical drugs. Therefore, their labeling may not always be accurate or comprehensive. Patients need to be aware of potential risks, interactions, and variations in potency associated with herbal products. Education helps patients make informed decisions and use these products safely.

B. Herbal products are approved under strict FDA regulations. This statement is false. Unlike pharmaceutical drugs, herbal products are regulated as dietary supplements in the United States and are not subject to the same level of scrutiny and approval processes by the FDA. While the FDA regulates the manufacturing and labeling of dietary supplements, including herbal products, the standards are not as strict as those for prescription or over-the-counter medications.

C. There are so few side effects, and they can be purchased without a prescription. This statement is misleading and potentially dangerous. Herbal products can indeed have side effects and interactions with medications, and their safety profiles vary widely. Additionally, the availability of herbal products without a prescription does not necessarily imply safety. Patients need education to understand potential risks and benefits associated with herbal product use.

D. The manufacturer has repeatedly demonstrated effectiveness. This statement is unsubstantiated and may not be true for all herbal products. Unlike pharmaceutical drugs, herbal products often lack extensive scientific evidence supporting their effectiveness for specific indications. While some manufacturers may conduct studies to support their products' efficacy, the evidence may be limited or inconclusive. Patients need education to critically evaluate claims of effectiveness and make informed decisions about herbal product use.

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A client taking warfarin (Coumadin) should be instructed to avoid herbal supplements such as green tea, ginkgo, feverfew, garlic, and ginger because these could:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When asked if there are any regulatory controls on herbal or dietary supplements, the nurse responds to the client by informing him that herbal and dietary supplements are regulated by the:

Correct Answer is D

Explanation

It is important that nurses ensure that their patients receive education regarding herbal products because:

Correct Answer is A

Explanation

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