A client is discharged with a prescription for warfarin. Which discharge instruction should the nurse emphasize to the client?

Take a multi-vitamin supplement daily.

Use an astringent for superficial bleeding.

Add large amounts of spinach to the diet.

Avoid going barefoot, especially outside.

Answer and Explanation

The Correct Answer is D

Choice A reason: Taking a multi-vitamin supplement daily is not a necessary instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. However, some vitamins, such as vitamin K, vitamin E, and vitamin C, can interact with warfarin and affect its effectiveness. Patients should consult their health care provider before taking any supplements or herbal products.

Choice B reason: Using an astringent for superficial bleeding is not a sufficient instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. Warfarin can increase the risk of bleeding, both internally and externally. Patients should report any signs of bleeding, such as bruising, nosebleeds, gum bleeding, blood in urine or stool, or prolonged bleeding from cuts or wounds, to their health care provider. They should also avoid activities or products that can increase the risk of bleeding, such as shaving with a razor, using dental floss, or taking aspirin or NSAIDs.

Choice C reason: Adding large amounts of spinach to the diet is an incorrect instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. Spinach is a leafy green vegetable that is high in vitamin K, which can counteract the effect of warfarin and increase the risk of clotting. Patients should maintain a consistent intake of vitamin K-rich foods and avoid sudden changes in their diet.

Choice D reason: Avoiding going barefoot, especially outside, is a correct instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. Warfarin can increase the risk of bleeding, both internally and externally. Patients should protect their feet from injury or infection by wearing shoes or slippers at all times.

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Correct Answer is D

Explanation

Choice A reason: Promoting stomach emptying and preventing gastric reflux is not a relevant action of sevelamer, which is a phosphate binder that lowers serum phosphate levels in patients with CKD. Gastric reflux may be caused by other factors, such as hiatal hernia, obesity, or spicy foods.

Choice B reason: Buffering hydrochloric acid and preventing gastric erosion is not a pertinent action of sevelamer, which does not affect gastric acidity or mucosal integrity. Gastric erosion may be caused by other factors, such as NSAIDs, alcohol, or Helicobacter pylori infection.

Choice C reason: Preventing indigestion associated with ingestion of spicy foods is not a significant action of sevelamer, which does not affect digestion or food tolerance. Indigestion may be caused by other factors, such as overeating, stress, or gallstones.

Choice D reason: Binding with phosphorus in foods and preventing absorption is the correct action of sevelamer, which should be taken with meals to reduce the amount of phosphorus that enters the bloodstream from the diet. High serum phosphate levels can cause bone loss, calcification of soft tissues, and secondary hyperparathyroidism in patients with CKD.

A. Expectorating bronchial secretions. B. Reports reduced nasal discharge. C. Able to sleep through the night. D. Denies having coughing spells.

Correct Answer is D

Explanation

Choice A reason: Expectorating bronchial secretions is not an assessment information that indicates that the antitussive medication benzonatate is effective. Benzonatate is a medication that suppresses the cough reflex by numbing the throat and lungs. It does not loosen or thin the mucus in the airways, which would facilitate expectoration.

Choice B reason: Reports reduced nasal discharge is not an assessment information that indicates that the antitussive medication benzonatate is effective. Benzonatate is a medication that suppresses the cough reflex by numbing the throat and lungs. It does not affect the production or drainage of nasal secretions, which are caused by inflammation and infection in the upper respiratory tract.

Choice C reason: Able to sleep through the night is not an assessment information that indicates that the antitussive medication benzonatate is effective. Benzonatate is a medication that suppresses the cough reflex by numbing the throat and lungs. It does not have any sedative or hypnotic effects, which would promote sleep. However, by reducing coughing, benzonatate may indirectly improve the quality of sleep for the client.

Choice D reason: Denies having coughing spells is an assessment information that indicates that the antitussive medication benzonatate is effective. Benzonatate is a medication that suppresses the cough reflex by numbing the throat and lungs. It reduces the frequency and intensity of coughing, which can relieve discomfort and irritation for the client.

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A client is discharged with a prescription for warfarin. Which discharge instruction should the nurse emphasize to the client?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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