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."
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
a) Vitamin D levels may be affected by long-term glucocorticoid use, but the described symptoms are more indicative of potential glucocorticoid-related side effects, such as Cushingoid features, which warrant liver function tests.
b) Liver function tests are appropriate to assess the impact of long-term glucocorticoid use on the liver, as these medications can affect liver function.
c) Serum electrolytes are important to monitor, but the specific symptoms mentioned (full cheeks, hump of fat) are not typically associated with electrolyte imbalances.
d) A tuberculin skin test is unrelated to the observed symptoms and is not typically ordered based on the physical features described.
Correct Answer is D
Explanation
a) Amlodipine is a calcium channel blocker and is less likely to cause angioedema compared to ACE inhibitors like captopril.
b) Budesonide is a corticosteroid and is not typically associated with angioedema.
c) Simvastatin is a statin and is not known to cause angioedema.
d) Captopril is an ACE inhibitor, and angioedema is a known adverse effect. In the presence of localized swelling of the lips and tongue, discontinuation of captopril is likely indicated.
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