A nurse is collecting data from a client who has a prosthetic aortic valve and takes warfarin daily at bedtime. Which of the following data is the priority finding for the nurse to report to the provider?
The client sprinkles flaxseeds on breakfast food every day.
The client keeps a small supply of vitamin K tablets on hand for emergency use.
The client uses garlic as a daily dietary supplement.
The client consistently eats fish for dinner twice weekly.
The Correct Answer is B
A. The client sprinkles flaxseeds on breakfast food every day. Flaxseeds contain omega-3 fatty acids, which can have antithrombotic effects. However, their impact on INR (International Normalized Ratio), the measure of warfarin's anticoagulant effect, is not well-established. While it's important to monitor the client's dietary intake of foods rich in vitamin K or those with potential antithrombotic effects, such as flaxseeds, this is not the priority finding among the options provided.
B. The client keeps a small supply of vitamin K tablets on hand for emergency use. This is the correct answer. Vitamin K is the antidote for warfarin, and the client should not keep a supply of vitamin K tablets on hand for emergency use. Warfarin's anticoagulant effect is carefully monitored through regular INR checks, and adjustments to the dosage are made accordingly. The presence of vitamin K tablets suggests a potential risk of self-adjusting warfarin dosage, which can lead to fluctuations in INR levels and increase the risk of thromboembolic or bleeding events.
C. The client uses garlic as a daily dietary supplement. Garlic is known to have potential antithrombotic effects and can interact with warfarin, increasing the risk of bleeding. However, its impact on INR levels may vary among individuals. While it's important to consider the use of garlic as a dietary supplement, it is not the priority finding among the options provided.
D. The client consistently eats fish for dinner twice weekly. Fish consumption, particularly those rich in omega-3 fatty acids such as salmon or mackerel, can have antithrombotic effects and may affect INR levels. However, the client's consistent fish consumption is less likely to have a significant impact on warfarin therapy compared to the potential self-administration of vitamin K tablets.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"B"}
Explanation
A. Minutes: This is too short a timeframe for warfarin's effect. It takes longer for the body's existing clotting factors to be depleted.
B. Days: This medication works by inhibiting the production of vitamin K-dependent clotting factors in the liver. As existing clotting factors are used up and new ones aren't produced as efficiently, it takes time for the anticoagulant effect to become significant.
C. Weeks: While the full effect might take some time (around 3-5 days), several weeks is an overestimation for most patients.
D. Hours: A few hours might show some initial effect, but it's not enough time for a substantial anticoagulant effect. It usually takes at least a day or two.
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"},"F":{"answers":"A"}}
Explanation
Essential
1. "Avoid taking other medications that can cause bleeding, such as NSAIDs like ibuprofen." Both aspirin and clopidogrel increase the risk of bleeding. NSAIDs like ibuprofen can further increase this risk, so it is crucial to avoid them unless advised otherwise by a healthcare provider.
2. "Continue to take your newly prescribed medications until your prescriber tells you not to do so." Discontinuing aspirin and clopidogrel without medical advice can increase the risk of stent thrombosis and other complications. It is essential to follow the prescribed regimen strictly.
3. “Report any unexpected bleeding to your primary health provider." Monitoring for signs of bleeding (such as bruising, blood in the stool or urine, or unusual bleeding) is important due to the increased bleeding risk associated with these medications. Prompt reporting can help manage and mitigate serious complications.
Unrelated
1. "Drink a glass of water after each dose of your new drug." While staying hydrated is generally good advice, it is not specifically relevant to the efficacy or safety of aspirin and clopidogrel.
2. "Follow up with the prescribed laboratory testing needed to monitor your clotting values." Routine clotting tests (such as INR, PT, or aPTT) are not typically required for monitoring the effects of aspirin and clopidogrel, as these medications do not usually require lab monitoring like warfarin does.
3. "Eat foods high in Vitamin K and calcium to help prevent clotting." This advice is unrelated because Vitamin K can counteract the effects of anticoagulants like warfarin but does not affect the action of antiplatelet drugs like aspirin and clopidogrel. Calcium intake is also unrelated to the management of these medications.
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