A client is receiving heparin sodium 5000 units IV and oral warfarin sodium 2.5 mg PO for thrombophlebitis in the left leg. The nurse educated the client that heparin and warfarin are both used because:

A. Loss of hair on the lower extremities can be a common sign of chronic PAD, indicating reduced blood
flow. While it’s an important observation, it is not an immediate concern.
B. Cold legs can indicate poor blood flow, which is a significant concern in PAD. The use of a heating pad can pose a risk of burns due to impaired sensation, especially in clients with poor circulation. This statement warrants immediate intervention, as the nurse should educate the client against using heat sources that can cause injury and assess the client's circulation and potential complications.
C. This describes claudication, a common symptom of PAD, where pain occurs in the legs due to inadequate blood flow during physical activity. While it indicates worsening symptoms of PAD, it is not an immediate emergency.
D. Reddish discoloration (rubor) when the legs are dependent can indicate blood pooling due to decreased venous return or arterial insufficiency. While this observation is significant and requires monitoring, it is not as urgent as the concern related to using a heating pad.

A. Heparin acts quickly to provide immediate anticoagulation, while warfarin takes several days to reach therapeutic levels. Heparin ensures that the client is adequately anticoagulated during the initial phase while waiting for warfarin to take effect.
B. Neither heparin nor warfarin directly dissolves clots. They are both anticoagulants that prevent further clot formation and allow the body's natural processes (fibrinolysis) to break down the existing clot over time. The combination does not specifically facilitate the dissolution of clots.
C. This statement is misleading. The use of both medications is not primarily about reducing the doses. Instead, each medication has its own dosing based on the patient’s needs, and the combination is used for timing and efficacy rather than dose reduction.
D. While heparin does provide immediate anticoagulation, saying it provides "maximum protection" could be misleading. It does ensure effective anticoagulation in the short term, but the maximum effectis related to individual response and therapeutic levels, which vary. Additionally, once warfarin reaches therapeutic levels, it becomes the primary agent for long-term anticoagulation.