A client who is taking warfarin (Coumadin) reports experiencing nosebleeds and easy bruising. Which of the following statements by the client indicates a need for further teaching?

Warfarin (Coumadin) is an anticoagulant that works by inhibiting the synthesis of vitamin K-dependent clotting factors. Vitamin K is found in foods such as green leafy vegetables, broccoli, liver, and soybeans.Eating foods that are high in vitamin K can decrease the effectiveness of warfarin and increase the risk of blood clots.

Choice B is wrong because warfarin can be taken with or without food.

Taking the medication with food does not affect its absorption or action.

Choice C is wrong because stopping warfarin abruptly can increase the risk of thromboembolism.

If the patient experiences bleeding, they should notify their health care provider and follow their instructions.

They may need to adjust their dose or switch to another medication.

Choice D is wrong because aspirin is also an anticoagulant that inhibits platelet aggregation.

Taking aspirin with warfarin can increase the risk of bleeding and bruising.

The patient should avoid taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless prescribed by their health care provider.

The patient who is taking warfarin should also have regular blood tests to monitor their international normalized ratio (INR), which measures how long it takes for their blood to clot.The target INR range for most patients is 2 to 3.

The patient should report any signs of bleeding, such as nosebleeds, gum bleeding, blood in urine or stool, or prolonged bleeding from cuts or wounds.

They should also report any signs of thrombosis, such as chest pain, shortness of breath, leg pain or swelling, or stroke symptoms.They should wear a medical alert bracelet or carry a card that identifies them as taking warfarin.

Warfarin (Coumadin) is an anticoagulant medication that prevents blood clots from forming or growing larger. It works by inhibiting the synthesis of vitamin K-dependent clotting factors in the liver. Warfarin can increase the risk of bleeding, so patients should monitor for signs of bleeding and report them to their healthcare provider.Some signs of bleeding are bruising, nosebleeds, gum bleeding, blood in urine or stool, and heavy menstrual bleeding.

Choice A is wrong because patients taking warfarin should not avoid foods that are high in vitamin K, but rather maintain a consistent intake of vitamin K.

Vitamin K is found in green leafy vegetables, such as spinach, kale, broccoli, and cabbage.Vitamin K can counteract the effects of warfarin and lower its effectiveness, so sudden changes in vitamin K intake can alter the patient’s response to warfarin.

Choice B is wrong because patients taking warfarin should not take aspirin for pain relief.

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can also inhibit platelet aggregation and increase the risk of bleeding.

Patients taking warfarin should avoid NSAIDs and other medications that can interact with warfarin, such as antibiotics, antifungals, anticonvulsants, and herbal supplements.Patients should consult their healthcare provider before taking any new medications or supplements.

Choice D is wrong because patients taking warfarin should not use a hard-bristled toothbrush.

A hard-bristled toothbrush can cause gum bleeding and increase the risk of oral infection.

Patients taking warfarin should use a soft-bristled toothbrush and floss gently to prevent gum bleeding.They should also avoid dental procedures that can cause bleeding, such as extractions, implants, or scaling.