A nurse is assisting in the education of a group of clients about the contraindications of warfarin therapy. Which of the following statements is appropriate to include in the instructions?

"Clients who have rheumatoid arthritis should not take warfarin."

"Clients who have diabetes mellitus type 1 should not take warfarin"

"Clients who have hypertension should not take warfarin"

"Clients who are pregnant should not take warfarin"

Answer and Explanation

The Correct Answer is D

A) "Clients who have rheumatoid arthritis should not take warfarin":
Rheumatoid arthritis itself is not a contraindication for warfarin therapy. However, close monitoring is required due to potential interactions with medications used to treat rheumatoid arthritis and the increased risk of bleeding associated with both conditions.

B) "Clients who have diabetes mellitus type 1 should not take warfarin":
Type 1 diabetes mellitus is not a contraindication for warfarin therapy. However, diabetes increases the risk of complications such as peripheral vascular disease, which may necessitate careful monitoring of INR levels and adjustments to warfarin dosage.

C) "Clients who have hypertension should not take warfarin":
Hypertension alone is not a contraindication for warfarin therapy. However, hypertension is a risk factor for cardiovascular diseases that may require anticoagulation therapy. Close monitoring of blood pressure and potential interactions with antihypertensive medications is essential.

D) "Clients who are pregnant should not take warfarin":
Pregnancy is a contraindication for warfarin therapy due to its teratogenic effects, which can cause fetal harm or birth defects. Pregnant clients requiring anticoagulation therapy may be prescribed alternative medications that are safer during pregnancy, under the guidance of a healthcare provider.

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Correct Answer is D

Explanation

A) Activated partial thromboplastin time (aPTT): This test is primarily used to monitor the effectiveness of heparin therapy, not warfarin. While aPTT measures the intrinsic pathway of coagulation, it is not the standard test for monitoring warfarin, which affects the extrinsic pathway and vitamin K-dependent clotting factors.

B) Platelet count: This test measures the number of platelets in the blood and is used to diagnose and monitor conditions related to platelet function, such as thrombocytopenia. However, it does not provide information about the anticoagulant effect of warfarin, which works by inhibiting vitamin K-dependent clotting factors.

C) White blood cell count (WBC): This test measures the number of white blood cells in the blood and is used to diagnose and monitor infections and inflammatory conditions. It is not relevant for monitoring the anticoagulant effect of warfarin, as WBC levels are not influenced by warfarin therapy.

D) Prothrombin time (PT): This is the correct test to monitor the effect of warfarin therapy. PT measures the extrinsic pathway of coagulation, which is directly influenced by warfarin. The international normalized ratio (INR) is derived from the PT and is used to standardize PT results, making it the most reliable indicator of warfarin’s anticoagulant effect. Regular monitoring of PT/INR helps ensure therapeutic levels are maintained while minimizing the risk of bleeding complications.

A. Protamine B. Epinephrine C. Atropine D. Vitamin K

Correct Answer is D

Explanation

A) Protamine:
Protamine is used to reverse the anticoagulant effects of heparin, not warfarin. It is not effective in reversing warfarin overdose.

B) Epinephrine:
Epinephrine is a medication used to treat severe allergic reactions (anaphylaxis) and cardiac arrest. It is not indicated for reversing warfarin overdose.

C) Atropine:
Atropine is used to treat bradycardia and certain types of poisoning but has no role in reversing the effects of warfarin overdose.

D) Vitamin K:
Vitamin K is the antidote for warfarin overdose. Warfarin inhibits vitamin K-dependent clotting factors, and administering vitamin K helps replenish these factors, thereby reversing the anticoagulant effects of warfarin.

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A nurse is assisting in the education of a group of clients about the contraindications of warfarin therapy. Which of the following statements is appropriate to include in the instructions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a new prescription for warfarin. The nurse should use the results of which of the following diagnostic tests to monitor the effect of this therapy?

Correct Answer is D

Explanation

A nurse is caring for a client who is receiving warfarin therapy to prevent a deep vein thrombosis. Which of the following medications should the nurse have available in the event of an overdose?

Correct Answer is D

Explanation

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