A nurse is caring for a client who has been taking warfarin and has an international normalized ratio (INR) time of 5. Which of the following medications should the nurse anticipate the provider to prescribe?

A. A patient with coronary artery disease (CAD) who reports chest pain radiating to the jaw: This patient should be evaluated first. Chest pain radiating to the jaw can be a sign of a heart attack, which is a life-threatening condition. Immediate medical attention is required to prevent further damage to the heart muscle.

B. A patient with venous insufficiency with 2+ pitting edema: While this patient’s condition needs to be addressed, it is not as immediately life-threatening as a potential heart attack. Venous insufficiency and edema can lead to discomfort and complications if left untreated, but these complications are typically not immediate.

C. A patient receiving enoxaparin (Lovenox) for experiencing an MI 3 days ago: This patient is already receiving treatment for their condition. While they should be monitored for side effects of the medication and signs of further cardiac issues, they are not the highest priority based on the information given.

D. A patient with peripheral artery disease (PAD) with a diminished pulse: While a diminished pulse can indicate poor blood flow, which can lead to complications such as tissue damage and non-healing wounds, it is not as immediately life-threatening as a potential heart attack. This patient should be evaluated, but they are not the highest priority based on the information given.

Answer: C. Orange ice pop

Rationale:

A) Ice cream: Although cold, ice cream can be thick and may stick to the throat, potentially causing discomfort and an urge to clear the throat, which could disrupt the healing tissue and increase bleeding risk.

B) Hot tea: Hot beverages can irritate the surgical site and increase the risk of bleeding due to the heat dilating blood vessels in the area. Cold or room temperature items are recommended post-tonsillectomy.

C) Orange ice pop: An orange ice pop is cold and soothing, which can reduce swelling and pain. Its smooth texture is easy on the throat and unlikely to cause irritation, making it an ideal snack post-tonsillectomy.

D) Cranberry juice: Cranberry juice is acidic and can irritate the throat, causing discomfort and possibly increasing inflammation at the surgical site. Non-acidic, cold foods are preferable to aid in comfort and healing.