A nurse is caring for a client who is scheduled for surgical repair of a femur fracture and has a prescription for lorazepam preoperatively. Which of the following statements made by the client should indicate to the nurse that the medication has been effective?

A. Ferrous sulfate: Ferrous sulfate is an iron supplement used to treat or prevent low blood levels of iron (such as those caused by anemia or pregnancy). It is not used to treat high INR levels.

B. Heparin: Heparin is an anticoagulant, or blood thinner, that prevents the formation of blood clots. It would not be used to treat a high INR level, as it could potentially increase the INR even further.

C. Prednisone: Prednisone is a corticosteroid that reduces inflammation in the body. It is not used to treat high INR levels.

D. Vitamin K: This is correct. Vitamin K is used to help blood clot and is given to patients who have a high INR level to reduce the risk of bleeding. Warfarin works by blocking the effects of vitamin K, so giving vitamin K can help reverse the effects of warfarin and lower the INR.

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.