A client taking warfarin presents with bruises, dark tarry stools, and an international normalized ratio (INR) of 4.3. What is the nurse's action?
Explain to the client the nurse may ask the provider to order a test for leukemia.
Hold the warfarin and consult the provider regarding the next steps.
Give an ampule of Vitamin K, then call the physician to report client status.
Give the warfarin with a dark green salad and check the next stool for blood.
The Correct Answer is B
a. The symptoms described (bruises, dark tarry stools, elevated INR) are indicative of warfarin overdose or excessive anticoagulation, not leukemia.
b. This is the correct answer because holding the warfarin is necessary to prevent further bleeding complications, and consulting the provider is essential for guidance on the next steps.
c. Giving Vitamin K may be necessary in cases of severe bleeding due to warfarin, but it is not the initial action. Consulting the provider is the priority.
d. Giving warfarin with a dark green salad may exacerbate the situation and increase the risk of bleeding. Checking the next stool for blood does not address the immediate issue of anticoagulation excess.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
a) St. John's Wort is known to increase the risk of bleeding, particularly when used in conjunction with anticoagulant medications. This effect is of concern and may require adjustments in the treatment plan.
b) While St. John's Wort can interact with various drugs, increasing the risk of bleeding is a more immediate concern.
c) St. John's Wort does not counteract the effects of CNS depressants; it may actually enhance the effects of these drugs.
d) St. John's Wort is known to induce the metabolism of some drugs, potentially reducing their effectiveness, but the immediate concern is the risk of bleeding.
Correct Answer is B
Explanation
a) Checking blood sugar once daily or more is a proactive and accurate self-management practice for individuals with diabetes.
b) Glipizide does not contain sulfa, so having a sulfa allergy is not a contraindication for taking this medication. The client needs clarification on this point.
c) Taking glipizide once daily with breakfast is a reasonable dosing schedule.
d) Having a glass of wine with dinner may be acceptable, but moderation and monitoring for interactions are advisable.
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