A client who is a vegetarian has a new prescription for warfarin. The client reports eating leafy green vegetables every day. How should the nurse respond?

Advise the client that the healthcare provider needs to be made aware of the current diet.

Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans.

Confirm that the clients diet choices will help the medication be more effective in preventing blood clots.

Commend the patient for a healthy lifestyle and encourage the client to continue current diet habits.

Answer and Explanation

The Correct Answer is A

A. Advise the client that the healthcare provider needs to be made aware of the current diet: This is the most appropriate response. Warfarin is an anticoagulant that works by inhibiting vitamin K, which is essential for blood clotting. Leafy green vegetables, such as spinach and kale, are high in vitamin K and can interfere with the effectiveness of warfarin. It is important for the healthcare provider to be aware of the client’s diet to properly adjust the warfarin dosage and ensure effective anticoagulation while minimizing the risk of bleeding or clotting.
B. Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans: This suggestion is not necessary unless there are specific dietary restrictions. While it's true that leafy green vegetables can affect warfarin, replacing them with other foods is not required. It’s more important to manage vitamin K intake consistently.
C. Confirm that the client’s diet choices will help the medication be more effective in preventing blood clots: This statement is incorrect. Leafy green vegetables can counteract the effects of warfarin due to their high vitamin K content.
D. Commend the patient for a healthy lifestyle and encourage the client to continue current diet habits: Although a diet rich in vegetables is generally healthy, it’s crucial to recognize that the high vitamin K content can impact the effectiveness of warfarin therapy. Therefore, simply encouraging the client to continue the current diet without considering its interaction with the medication is not appropriate

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Correct Answer is A

Explanation

A. Hypokalemia: Hydrochlorothiazide is a thiazide diuretic that can cause potassium loss through increased urine production. A common side effect of thiazide diuretics is hypokalemia, which can lead to symptoms such as palpitations or the sensation of the heart skipping beats. Therefore, it is crucial to check the client’s potassium levels to determine if hypokalemia is contributing to the client's symptoms.
B. Hyponatremia: While thiazide diuretics can affect sodium levels, hypokalemia is more directly associated with the symptoms described. Hyponatremia (low sodium levels) might also occur but is less commonly linked to the symptom of a skipped heartbeat compared to hypokalemia.
C. Hyperphosphatemia: Hydrochlorothiazide is not known to cause significant changes in phosphate levels, and hyperphosphatemia is not typically associated with the sensation of skipped heartbeats.
D. Hypermagnesemia: This condition, which involves elevated magnesium levels, is not a common side effect of hydrochlorothiazide. Hypokalemia is a more relevant concern for the symptoms described.

A. Leave the patch in place and administer a PRN dose of sublingual nitroglycerin. B. Reassure the client that the patch will begin to take effect within a few minutes. C. Withhold further doses of nitroglycerin until contacting the healthcare provider. D. Obtain another transdermal patch and position it on the patient's left upper chest.

Correct Answer is A

Explanation

A. Leave the patch in place and administer a PRN dose of sublingual nitroglycerin: It is appropriate to administer a PRN dose of sublingual nitroglycerin for immediate relief of acute angina while leaving the transdermal patch in place. The sublingual nitroglycerin acts quickly to relieve chest pain, while the transdermal patch provides a longer, more sustained effect.
B. Reassure the client that the patch will begin to take effect within a few minutes: The transdermal patch generally takes 30 to 60 minutes to reach therapeutic levels, which is not suitable for immediate relief of acute chest pain. Therefore, reassurance alone may not address the current symptoms effectively.
C. Withhold further doses of nitroglycerin until contacting the healthcare provider: Withholding further doses of nitroglycerin without assessing the situation can delay appropriate relief of chest pain. Immediate intervention is necessary, and it is appropriate to use sublingual nitroglycerin as needed.

D. Obtain another transdermal patch and position it on the patient's left upper chest: Applying an additional transdermal patch is not necessary and could lead to excessive nitroglycerin exposure. The current patch should be left in place, and sublingual nitroglycerin can be used for acute symptoms.

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A client who is a vegetarian has a new prescription for warfarin. The client reports eating leafy green vegetables every day. How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a home visit, a client informs the nurse about feeling like the heart is skipping beats. When reviewing the client's record, the nurse notes that the client is taking hydrochlorothiazide. Based on these assessment data, the nurse plans to obtain a blood sample to check for which condition?

Correct Answer is A

Explanation

A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?

Correct Answer is A

Explanation

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