The nurse is planning discharge education for a female client who is prescribed warfarin. What information should the nurse plan to include in the teaching? Select all that apply.
Regular laboratory monitoring is required.
Inject this drug subcutaneously in the abdomen.
Avoid medications containing aspirin.
Report heavy menstrual bleeding to the provider.
There are no dietary interactions with warfarin.
Correct Answer : A,C,D
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Red blood cells: While red blood cell counts provide information about oxygen-carrying capacity and anemia, they do not directly reflect the anticoagulant effect of heparin or the risk of bleeding due to its use. Monitoring RBCs is not sufficient for safe heparin therapy.
B. International normalized ratio (INR): INR is primarily used to monitor warfarin therapy, not heparin. It measures the extrinsic pathway of coagulation, whereas heparin affects the intrinsic pathway, so INR is not the appropriate laboratory value for heparin monitoring.
C. Partial thromboplastin time (PTT): PTT measures the effectiveness of the intrinsic and common coagulation pathways, which are directly affected by heparin. Monitoring PTT helps ensure that the client maintains a therapeutic anticoagulation range and reduces the risk of bleeding or clot formation.
D. Hematocrit: Hematocrit reflects the proportion of red blood cells in the blood and can indicate blood loss over time. While important for general assessment, it does not specifically monitor heparin’s anticoagulant effect and is not the primary lab value to guide dosing.
Correct Answer is D
Explanation
A. Urinary frequency: Nitroglycerin does not affect renal function in a way that would cause increased urination. Urinary frequency is not a recognized side effect of nitroglycerin therapy.
B. Dry cough: Dry cough is commonly associated with ACE inhibitors, not nitroglycerin. Nitroglycerin’s pharmacologic effects do not typically involve the respiratory system in this manner.
C. Hypoglycemia: Nitroglycerin does not alter blood glucose levels. Hypoglycemia is unrelated to its mechanism of action as a vasodilator.
D. Flushing: Flushing is a common side effect of nitroglycerin due to peripheral vasodilation. The widening of blood vessels increases blood flow to the skin, resulting in warmth and redness, which is typically mild and transient.
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