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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. LMWHs produce a more stable effect on coagulation; thus, fewer lab tests are needed: Correct LMWHs have a more predictable anticoagulant response compared to unfractionated heparin, resulting in a more stable effect on coagulation. Because of their predictable response, routine monitoring of coagulation parameters, such as activated partial thromboplastin time (aPTT), is typically not required with LMWH therapy, unlike with unfractionated heparin.

B. LMWHs may be given by the oral route: Incorrect. LMWHs are administered by the subcutaneous route.

C. LMWHs have a short duration of action: Incorrect. LMWHs have a longer duration of action compared to unfractionated heparin.

D. LMWHs possess greater anticoagulant activity: incorrect. LMWHs generally have less potent anticoagulant activity compared to unfractionated heparin, but their more predictable response and longer half-life make them advantageous in many clinical scenario

A. If he misses a dose, he should double the dose at the next scheduled time. B. The client should use an electric razor while on this medication. C. Mild nosebleeds are common during initial treatment. D. Warfarin increases the risk for deep vein thrombosis.

Correct Answer is B

Explanation

A. If he misses a dose, he should double the dose at the next scheduled time: This statement is incorrect. Doubling the dose of warfarin after missing a dose can significantly increase the risk of bleeding due to excessive anticoagulation. The nurse should emphasize the importance of taking the medication as prescribed and what to do if a dose is missed, such as contacting the healthcare provider for guidance.

B. The client should use an electric razor while on this medication: This statement is correct. Warfarin is an anticoagulant medication that can increase the risk of bleeding. Therefore, it's essential for patients taking warfarin to avoid activities that may increase the risk of injury or bleeding, such as shaving with a traditional razor that can cause cuts or nicks. Using an electric razor reduces this risk.

C. Mild nosebleeds are common during initial treatment: This statement is not entirely accurate. While warfarin can increase the risk of bleeding, including nosebleeds, it's not necessarily common during the initial treatment phase. However, patients should be aware of signs of bleeding and report them to their healthcare provider promptly.

D. Warfarin increases the risk for deep vein thrombosis: This statement is incorrect. Warfarin is actually prescribed to reduce the risk of blood clots, including deep vein thrombosis (DVT), pulmonary embolism (PE), and stroke, in patients who are at risk for these conditions. It works by inhibiting the formation of blood clots. Therefore, it does not increase the risk of DVT; rather, it decreases it.

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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?

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