A nurse is preparing discharge teaching for a client who will be going home on warfarin. Which of these client statements indicates the need for further instruction?

"I should avoid alcohol and herbal remedies while I am taking warfarin."

"If I notice signs of bleeding I will stop taking warfarin and follow up with my doctor in a week."

"I should be consistent with my intake of leafy greens while I am taking warfarin."

"I should have my international normalized ratio (INR) checked regularly while I am on warfarin."

Answer and Explanation

The Correct Answer is B

a) Avoiding alcohol and herbal remedies is a correct instruction because they can interact with warfarin and increase the risk of bleeding.

b) Stopping warfarin abruptly without healthcare provider guidance can be dangerous and increase the risk of thrombosis. Signs of bleeding should be reported promptly to the healthcare provider for appropriate management.

c) Being consistent with the intake of leafy greens is important to maintain a stable INR, as these foods contain vitamin K, which can interfere with warfarin.

d) Regular INR monitoring is essential to ensure that the client is within the therapeutic range and to make adjustments to the warfarin dosage if necessary.

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Correct Answer is D

Explanation

a) While discussing possible opiate dependence is important, the immediate concern is the client's respiratory depression and altered level of consciousness, which may require naloxone administration.

b) Noting the effectiveness of analgesia is relevant but does not address the current respiratory depression and lethargy observed in the client.

c) Encouraging the client to turn over and cough may not be effective in addressing severe respiratory depression, and immediate intervention is needed.

d) The client's symptoms, including drowsiness, lethargy, pinpoint pupils, and respiratory depression, are consistent with opioid overdose. Naloxone is the antidote for opioid toxicity and should be administered promptly.

A. Liver disease B. Gender C. Height D. Age E. Genetic factors

Correct Answer is ["A","C","D","E"]

Explanation

a) Liver disease can affect drug metabolism and clearance, influencing the response to medications.

b) Gender may play a role in drug response, as there are some gender-related differences in drug metabolism and distribution.

c) Height can influence drug dosing, especially for medications with weight-based dosing.

d) Age is a crucial factor in drug response, as the metabolism and elimination of drugs can vary across different age groups.

e) Genetic factors, including variations in drug-metabolizing enzymes and drug receptors, can significantly impact an individual's response to a drug.

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A nurse is preparing discharge teaching for a client who will be going home on warfarin. Which of these client statements indicates the need for further instruction?

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A nurse is preparing discharge teaching for a client who will be going home on warfarin. Which of these client statements indicates the need for further instruction?