A nurse receives her client back from the operating room and observes fresh blood on the sheets. The nurse realizes that the client's incision is bleeding and documentation shows that the client received a double dose of intravenous heparin in the operating room. What action should the nurse take?

A. Regular laboratory monitoring is required: Warfarin therapy necessitates frequent monitoring of the international normalized ratio (INR) to ensure therapeutic anticoagulation and to prevent bleeding or clotting complications.

B. Inject this drug subcutaneously in the abdomen: Warfarin is administered orally, not via injection. Teaching injection techniques is not applicable and could cause confusion or medication errors.

C. Avoid medications containing aspirin: Aspirin and other NSAIDs can increase the risk of bleeding when taken with warfarin due to additive antiplatelet effects. Clients should be educated to avoid these medications unless approved by their healthcare provider.

D. Report heavy menstrual bleeding to the provider: Heavy or unusual bleeding is a potential sign of warfarin over-anticoagulation. Clients should be instructed to report such symptoms promptly for assessment and possible dosage adjustment.

E. There are no dietary interactions with warfarin: Warfarin interacts with foods high in vitamin K (e.g., leafy greens), which can affect its effectiveness. Clients should be educated on maintaining consistent dietary vitamin K intake rather than assuming no dietary interactions exist.

A. Clarify the order with the healthcare provider: The order for digoxin 25 mg IV is dangerously high and far exceeds the usual therapeutic dose (typically micrograms, not milligrams). The nurse must verify the order before administration to prevent life-threatening toxicity.

B. Listen to the apical pulse for one minute: While assessing the apical pulse is essential before administering digoxin to check for bradycardia, verifying the unusually high dose takes priority to ensure client safety.

C. Obtain a current blood pressure reading: Monitoring blood pressure is important because digoxin can affect cardiac output, but confirming the safety of the ordered dose comes before vital sign assessment in this scenario.

D. Ensure the client's IV site is patent: Ensuring IV patency is necessary for safe medication administration, but it is secondary to clarifying an unsafe order to prevent immediate harm to the client.