Which of the following would be included in bleeding precautions for a client taking warfarin? SELECT ALL THAT APPLY

Use soft bristled tooth brush

Report black or bloody bowel movements

Limit all fruits and vegetables

Report coffee ground or bloody emesis

Shave with electric razor instead of razor blade

Answer and Explanation

Correct Answer : A,B,D,E

Choice A reason: Using a soft bristled tooth brush can prevent gum bleeding and irritation that may occur with a hard bristled tooth brush. Gum bleeding can be a sign of excessive anticoagulation and increased risk of bleeding.

Choice B reason: Reporting black or bloody bowel movements is important because it can indicate gastrointestinal bleeding, which can be a serious complication of warfarin therapy. Gastrointestinal bleeding can cause anemia, shock, and even death if not treated promptly.

Choice C reason: Limiting all fruits and vegetables is not necessary for a client taking warfarin. However, some fruits and vegetables, especially those that are high in vitamin K, can interfere with the effect of warfarin and increase the risk of clotting. Vitamin K is found in green leafy vegetables, such as spinach, kale, broccoli, and cabbage, and some fruits, such as avocado, kiwi, and grapes. The client should maintain a consistent intake of vitamin K and avoid sudden changes in their diet.

Choice D reason: Reporting coffee ground or bloody emesis is also important because it can indicate upper gastrointestinal bleeding, which can be another serious complication of warfarin therapy. Upper gastrointestinal bleeding can cause hematemesis, melena, anemia, and hypovolemic shock.

Choice E reason: Shaving with an electric razor instead of a razor blade can prevent skin cuts and bleeding that may occur with a razor blade. Skin cuts and bleeding can be a sign of excessive anticoagulation and increased risk of bleeding.

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Correct Answer is ["2500"]

Explanation

The nurse needs to administer 2.5 L of 0.45% sodium chloride IV over 24 hours.

We know that 1 L is equal to 1000 mL.

So, 2.5 L is equal to 2.5 x 1000 mL/L = 2500 mL

Therefore, the nurse should administer 2500 mL over 24 hours.

A. You must check your heart rate before each dose B. Do not take with acetaminophen as it may cause bleeding C. Immediately report dry cough or blood sugar over 80 D. Avoid bananas, cantaloupe, and spinach

Correct Answer is D

Explanation

Choice A reason: This is incorrect because spironolactone does not affect the heart rate. Checking the heart rate before each dose is not necessary.

Choice B reason: This is incorrect because spironolactone does not interact with acetaminophen. Taking acetaminophen with spironolactone will not cause bleeding.

Choice C reason: This is incorrect because spironolactone does not cause dry cough or increase blood sugar. These are not signs of adverse effects of spironolactone.

Choice D reason: This is correct because spironolactone can cause hyperkalemia, which is a high level of potassium in the blood. Bananas, cantaloupe, and spinach are high-potassium foods that should be avoided by clients taking spironolactone.

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Which of the following would be included in bleeding precautions for a client taking warfarin? SELECT ALL THAT APPLY

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer 0.45% sodium chloride 2.5 L IV to infuse over 24 hr. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["2500"]

Explanation

What patient education should be given to a client going home with a new prescription for the potassium-sparing diuretic spironolactone?

Correct Answer is D

Explanation

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