A nurse is reinforcing discharge teaching for a client who will be taking warfarin (Coumadin) at home. Which of the following statements indicates that the client understands the effects of this medication?
To be sure to eat foods with lots of vitamin K.
Not to take aspirin for my headaches.
That it's okay to have a couple of glasses of wine with dinner.
To use my electric razor for shaving.
The Correct Answer is B
Choice A : While vitamin K is essential for normal blood clotting, warfarin works by blocking the action of vitamin K. Therefore, clients taking warfarin should maintain a consistent intake of vitamin K-rich foods to avoid fluctuations in their response to the medication. Inconsistent vitamin K intake can affect the effectiveness of warfarin. The nurse should educate the client to consume a consistent amount of vitamin K-containing foods rather than emphasizing "lots" of vitamin K.
Choice B : Warfarin is an anticoagulant that increases the risk of bleeding. Taking aspirin (another blood-thinning medication) along with warfarin can further enhance this risk. The nurse should emphasize that clients should avoid taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) without consulting their healthcare provider while on warfarin therapy.
Choice C : Alcohol can interact with warfarin and increase the risk of bleeding. Clients should be advised to limit alcohol consumption while taking warfarin. The nurse should educate the client that alcohol intake should be moderate and consistent, rather than encouraging wine consumption.
Choice D :While it is essential to minimize the risk of cuts and bleeding, the use of an electric razor is not specific to warfarin therapy. Clients should be cautious with any sharp objects, including razors, to prevent bleeding. The nurse should provide general safety instructions for shaving, but this choice does not directly relate to warfarin effects.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason : A fixed volume deficit, or hypovolemia, is not a direct finding associated with bradycardia. Bradycardia refers to a slower than normal heart rate, typically below 60 beats per minute in adults⁸. Hypovolemia can cause various compensatory mechanisms to activate, including an increase in heart rate to maintain cardiac output, which is the opposite of bradycardia. Therefore, a fixed volume deficit is not a typical finding in bradycardia unless it is part of a broader clinical picture⁹.
Choice B reason : Anxiety is a condition that can sometimes lead to an increased heart rate, known as tachycardia, rather than a decreased heart rate as seen in bradycardia. While anxiety can coexist with bradycardia, especially if the patient is anxious about their health, it is not a direct symptom or finding of bradycardia itself⁹.
Choice C reason : Lightheadedness is a common symptom of bradycardia. When the heart rate is too slow, it may lead to inadequate cerebral perfusion, which can cause a feeling of lightheadedness or dizziness. This symptom can be particularly evident when the patient changes positions, such as standing up quickly, which can exacerbate the effects of reduced cardiac output on cerebral blood flow⁸⁹.
Choice D reason : An elevated temperature is not typically associated with bradycardia. Fever can actually lead to an increased heart rate as the body attempts to manage the higher metabolic demands associated with a raised temperature. Bradycardia in the presence of fever might indicate a more complex clinical scenario, such as myocarditis or central nervous system infections, but it is not a direct finding of bradycardia⁹.
Correct Answer is D
Explanation
Choice A reason : Morphine is an opioid analgesic used to relieve severe pain and can be administered to patients with myocardial infarction to alleviate chest pain and anxiety. However, it is not the first medication given as it does not address the underlying cause of the myocardial infarction, which is the formation of a blood clot in the coronary arteries.
Choice B reason : Nitroglycerin is a nitrate that helps to dilate blood vessels and improve blood flow. It can be used to relieve chest pain in myocardial infarction, but similar to morphine, it is not the initial medication of choice. The priority is to prevent further blood clotting.
Choice C reason : Administered as soon as possible to inhibit platelet aggregation and reduce clot progression.
Choice D reason : When a myocardial infarction (MI) is suspected, the priority is to address tissue hypoxia and ensure adequate oxygenation to minimize myocardial damage. Administering oxygen helps increase oxygen availability to the ischemic heart tissue, reducing further damage.
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