An older adult patient has been prescribed warfarin (coumadin). The nurses primary intervention involves daily review of the patient's:

reflex tone

body for bruising

serum creatinine level

prothrombin time

Answer and Explanation

The Correct Answer is D

A.   Reflex tone refers to the neurological response of the body to stimuli and is not directly related to the action or monitoring of anticoagulant therapy. While assessing reflexes might be important for overall patient health, it is not specifically relevant to monitoring the effects of warfarin. Reflex tone does not provide information on the anticoagulation status or risk of bleeding associated with warfarin therapy.
B.   Checking the body for bruising helps assess the safety of warfarin therapy and may indicate the need for dosage adjustments or further investigation if bruising is excessive. However, while monitoring for bruising is essential, it is not the primary method for assessing the effectiveness and safety of anticoagulant therapy.
C.   While monitoring kidney function is relevant for overall medication management, it is not the primary focus for directly assessing the effectiveness or safety of warfarin therapy. Kidney function is more related to adjusting doses and avoiding potential complications.
D.   Regularly reviewing PT is crucial for managing warfarin therapy because it directly reflects the anticoagulation effect of the medication. The International Normalized Ratio (INR), derived from PT, is used to ensure the patient is within the therapeutic range for effective anticoagulation while minimizing the risk of bleeding.

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Correct Answer is D

Explanation

A. While lack of energy can be a barrier to exercise, it is not as specific to the fear of falling.
B. This is a common barrier to exercise for many people, but it does not specifically address the fear of falling.

C. If the patient is experiencing pain with movement, it is important to address this before starting an exercise program. However, fear of falling is a more specific concern related to osteoporosis.
D. Osteoporosis is a condition characterized by decreased bone density, which can increase the risk of fractures. A walking program can help improve bone health and reduce the risk of falls. However, many people with osteoporosis may be reluctant to start a walking program due to fear of falling.

A. informs the patients physician about the drug noncompliance B. checks the drug guide to see if decreasing the frequency if the drugs is possible C. asks the patients spouse to consistently administer the drugs D. teaches the patient to administer daily pills with a pill dispenser

Correct Answer is D

Explanation

A. While it's important to communicate any concerns about medication adherence with the physician, the nurse should first try to address the underlying issue, which in this case is the patient's memory impairment.
B. While decreasing the frequency of medications may be possible in some cases, it's important to consult with the physician before making any changes to the medication regimen.
C. Relying on a family member to administer medications can be problematic, as it may not be feasible for them to do so on a regular basis. It's important for the patient to take responsibility for their own medication management, with the support of the nurse.
D. Memory impairment is a common problem in older adults and can affect medication adherence. Using a pill dispenser can help patients remember when to take their medications. Pill dispensers are often organized by day and time, making it easier for patients to keep track of their medication schedule.

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An older adult patient has been prescribed warfarin (coumadin). The nurses primary intervention involves daily review of the patient's:

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Naxlex Comprehensive Predictor Exams

A nurse is working with a woman who has been reluctant to start a walking program for her osteoporosis. What assessment by the nurse is most important?

Correct Answer is D

Explanation

An older adult patient is having difficulty remembering when to take several of the prescribed medications. To improve the patient's compliance with the medication regimen, the nurse.

Correct Answer is D

Explanation

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