A nurse is caring for a client who is taking warfarin (Coumadin). Which of the following statements by the client indicates an understanding of the medication?

Warfarin (Coumadin) is an anticoagulant medication that prevents blood clots from forming or growing larger. It works by inhibiting the synthesis of vitamin K-dependent clotting factors in the liver. Warfarin can increase the risk of bleeding, so patients should monitor for signs of bleeding and report them to their healthcare provider.Some signs of bleeding are bruising, nosebleeds, gum bleeding, blood in urine or stool, and heavy menstrual bleeding.

Choice A is wrong because patients taking warfarin should not avoid foods that are high in vitamin K, but rather maintain a consistent intake of vitamin K.

Vitamin K is found in green leafy vegetables, such as spinach, kale, broccoli, and cabbage.Vitamin K can counteract the effects of warfarin and lower its effectiveness, so sudden changes in vitamin K intake can alter the patient’s response to warfarin.

Choice B is wrong because patients taking warfarin should not take aspirin for pain relief.

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can also inhibit platelet aggregation and increase the risk of bleeding.

Patients taking warfarin should avoid NSAIDs and other medications that can interact with warfarin, such as antibiotics, antifungals, anticonvulsants, and herbal supplements.Patients should consult their healthcare provider before taking any new medications or supplements.

Choice D is wrong because patients taking warfarin should not use a hard-bristled toothbrush.

A hard-bristled toothbrush can cause gum bleeding and increase the risk of oral infection.

Patients taking warfarin should use a soft-bristled toothbrush and floss gently to prevent gum bleeding.They should also avoid dental procedures that can cause bleeding, such as extractions, implants, or scaling.

This statement indicates a need for further teaching because taking an antacid can interfere with the absorption of warfarin and affect its effectiveness. The client should not self-medicate with any over-the-counter drugs without consulting their healthcare provider first.

Choice A is wrong because reporting black tarry stools and abdominal pain to the healthcare provider immediately is the appropriate action.These symptoms may indicate gastrointestinal bleeding, which is a serious adverse effect of warfarin.

Choice B is wrong because stopping the medication if these symptoms persist is not advisable.Warfarin should not be discontinued abruptly without medical supervision, as this can increase the risk of thrombosis.

Choice D is wrong because increasing the intake of green leafy vegetables is not harmful.

Green leafy vegetables are rich in vitamin K, which is the antidote for warfarin overdose.However, the client should maintain a consistent intake of vitamin K and avoid sudden changes in their diet.