A male client with dementia is admitted to the emergency department (ED) because he accidentally self-administered several doses of diltiazem. Which intervention is most important for the nurse to implement?

A. Instruct the client that since the hematocrit remains low, the daily injections are still necessary: A hematocrit of 43% is within the normal range, suggesting the client’s anemia is improving. If the hematocrit were still low, continuing daily injections would be appropriate, but this is not the case here.

B. Notify the healthcare provider of the client’s hematocrit level so the frequency of injections can be reduced: Since the hematocrit is normal, there is no need to notify the healthcare provider specifically for changing the injection frequency based solely on the hematocrit level. Reducing injection frequency should be based on the overall treatment plan and not just the current hematocrit.
C. Advise the client that the medication is having the desired effect, but daily injections will continue to be needed for life for this chronic condition: While the medication may be effective, informing the client about the potential for less frequent injections could improve adherence and reduce discomfort, if the healthcare provider approves.
D. Offer to instruct the client in self-administration techniques to improve the client's sense of control over the painful daily injections: Teaching self-administration can empower the client and potentially reduce discomfort by allowing the client to become more comfortable with the process. It also offers the opportunity for the client to manage their injections more conveniently and with greater control.

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