An older patient with chronic atrial fibrillation develops sudden severe pain, pulselessness, pallor, and coolness in the right leg, consistent with acute arterial occlusion.

After the nurse notifies the healthcare provider, what should the nurse do next?

Choice A rationale
Iron supplements for anemia do not typically interact with warfarin (Coumadin). Iron is a mineral that is essential for the production of red blood cells, and supplements are often prescribed to patients with anemia to increase their iron levels. While it’s important for healthcare providers to be aware of all medications and supplements a patient is taking, iron supplements are not known to diminish the effects of warfarin.
Choice B rationale
Furosemide (Lasix) is a diuretic medication used to treat fluid retention. It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine. While furosemide can interact with other medications, it is not known to diminish the effects of warfarin.
Choice C rationale
Simvastatin (Zocor) is a medication used to control cholesterol levels. It works by slowing the production of cholesterol in the body to decrease the amount of cholesterol that may build up on the walls of the arteries and block blood flow to the heart, brain, and other parts of the body. Simvastatin does not typically interact with warfarin to diminish its effects.
Choice D rationale
Yaz (drospirenone/estradiol) is an oral contraceptive that contains estrogen. Estrogen can potentially increase the effects of warfarin, leading to an increased risk of bleeding. Therefore, if a patient taking warfarin also takes Yaz, it could potentially diminish the effects of warfarin, making it less effective. This is why it’s important for healthcare providers to be aware of all medications a patient is taking, including oral contraceptives.

Choice A rationale
Recurring chest pain can be a symptom of a serious condition such as a heart attack, which can occur if a blood clot forms in a vein deep inside the body, breaks off, and travels to the heart.
This is a potential complication of Deep Vein Thrombosis (DVT) and other vascular issues. Therefore, it’s important for the nurse to inquire about recurring chest pain in a patient with a past history of DVT and other vascular issues.
Choice B rationale
A peptic ulcer is a sore that develops on the lining of the stomach, upper small intestine, or lower esophagus. While peptic ulcers can cause discomfort and other symptoms, they are not typically associated with DVT or other vascular issues. Therefore, while it’s always important for the nurse to have a complete understanding of a patient’s health history, inquiring about a peptic ulcer may not be directly relevant to a patient with a past history of DVT and other vascular issues.
Choice C rationale
An aneurysm is a bulge or ballooning in the wall of an artery. Aneurysms can occur in any artery in the body, and they can be life-threatening if they rupture or dissect (tear)3. While aneurysms can be associated with certain vascular diseases, they are not typically associated with DVT3. Therefore, while it’s important for the nurse to be aware of a patient’s complete health history, inquiring about an aneurysm may not be directly relevant to a patient with a past history of DVT.
Choice D rationale
Rheumatoid arthritis is an autoimmune disease that causes inflammation in the joints. While it can cause a variety of symptoms and complications, it is not typically associated with DVT or other vascular issues. Therefore, while it’s always important for the nurse to have a complete understanding of a patient’s health history, inquiring about rheumatoid arthritis may not be directly relevant to a patient with a past history of DVT and other vascular issues.