A client taking warfarin (Coumadin) should be instructed to avoid herbal supplements such as green tea, ginkgo, feverfew, garlic, and ginger because these could:

A. Constipation: Constipation is not a commonly reported adverse effect of clopidogrel (Plavix). Clopidogrel is an antiplatelet medication that works by inhibiting platelet aggregation, and gastrointestinal effects such as constipation are not typically associated with its use.

B. Bruising: This is a correct answer. Bruising is a known adverse effect of clopidogrel. As an antiplatelet medication, clopidogrel inhibits platelet aggregation, which can increase the risk of bleeding and bruising.

C. Rash: Rash is a potential adverse effect of clopidogrel, although it is not as common as other side effects such as bruising or gastrointestinal symptoms. Patients taking clopidogrel should be monitored for signs of allergic reactions, including rash, which may indicate the need for further evaluation or discontinuation of the medication.

D. Headache: Headache is not a commonly reported adverse effect of clopidogrel. While some patients may experience headache while taking clopidogrel, it is not considered a frequent or significant side effect of the medication.

E. Diarrhea: Diarrhea is not a commonly reported adverse effect of clopidogrel. Gastrointestinal symptoms such as diarrhea are not typically associated with clopidogrel use, although some patients may experience gastrointestinal upset as a side effect of antiplatelet therapy.

A. Platelets 74,000/mm: A platelet count of 74,000/mm³ is significantly lower than the normal range (typically 150,000 to 450,000/mm³). This could indicate heparin-induced thrombocytopenia (HIT), a serious adverse effect of heparin therapy where the immune system forms antibodies against heparin bound to platelet factor 4, leading to a decrease in platelets and increased risk of thrombosis. This is a critical finding and should be reported immediately to the provider for further evaluation and potential adjustment of the treatment plan.

B. White blood cell count 8,000/mm³: This is within the normal range (typically 4,000 to 11,000/mm³) and does not indicate an immediate problem related to heparin therapy or pulmonary embolism management.

C. Partial thromboplastin time (PTT) 55 seconds: While slightly elevated, this PTT is within the therapeutic range for a patient receiving IV heparin (typically 1.5 to 2.5 times the normal control value, or about 45 to 70 seconds). This indicates that the heparin is having the desired anticoagulant effect.

D. Hematocrit 45%: This is within the normal range for adults (typically 38-50% for men and 35-45% for women) and does not indicate an immediate concern related to heparin therapy or pulmonary embolism.