A nurse is assisting in the education of a group of clients about the contraindications of warfarin therapy. Which of the following statements is appropriate to include in the instructions?

"Clients who have rheumatoid arthritis should not take warfarin."

"Clients who have diabetes mellitus type 1 should not take warfarin"

"Clients who have hypertension should not take warfarin"

"Clients who are pregnant should not take warfarin"

Answer and Explanation

The Correct Answer is D

A) "Clients who have rheumatoid arthritis should not take warfarin":
Rheumatoid arthritis itself is not a contraindication for warfarin therapy. However, close monitoring is required due to potential interactions with medications used to treat rheumatoid arthritis and the increased risk of bleeding associated with both conditions.

B) "Clients who have diabetes mellitus type 1 should not take warfarin":
Type 1 diabetes mellitus is not a contraindication for warfarin therapy. However, diabetes increases the risk of complications such as peripheral vascular disease, which may necessitate careful monitoring of INR levels and adjustments to warfarin dosage.

C) "Clients who have hypertension should not take warfarin":
Hypertension alone is not a contraindication for warfarin therapy. However, hypertension is a risk factor for cardiovascular diseases that may require anticoagulation therapy. Close monitoring of blood pressure and potential interactions with antihypertensive medications is essential.

D) "Clients who are pregnant should not take warfarin":
Pregnancy is a contraindication for warfarin therapy due to its teratogenic effects, which can cause fetal harm or birth defects. Pregnant clients requiring anticoagulation therapy may be prescribed alternative medications that are safer during pregnancy, under the guidance of a healthcare provider.

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Correct Answer is B

Explanation

A) Serum calcium 10.5 mg/dL:
A serum calcium level of 10.5 mg/dL is within the normal range (8.5-10.5 mg/dL). Spironolactone does not typically affect calcium levels significantly.

B) Serum potassium 5.2 mEq/L:
An elevated serum potassium level (hyperkalemia) is a known adverse effect of spironolactone. Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, leading to decreased potassium excretion and potential hyperkalemia, especially in clients with impaired renal function.

C) Serum chloride 99 mEq/L:
A serum chloride level of 99 mEq/L is within the normal range (96-106 mEq/L). Spironolactone does not typically affect chloride levels significantly.

D) Serum sodium 140 mEq/L:
A serum sodium level of 140 mEq/L is within the normal range (135-145 mEq/L). Spironolactone does not typically affect sodium levels significantly.

A. "I take my alendronate at the same day every week with an 8-ounce glass of milk." B. "I sit up and read the morning paper after taking my alendronate," C. "I will need to have a bone density test occasionally while taking this medication." D. "I take my other pills at least 30 min after my alendronate,"

Correct Answer is B

Explanation

A) "I take my alendronate at the same day every week with an 8-ounce glass of milk":
Taking alendronate with a full glass of plain water, not milk or any other beverage, is recommended to optimize absorption and minimize the risk of esophageal irritation. Using milk may interfere with the absorption of the medication.

B) "I sit up and read the morning paper after taking my alendronate,":
While it's important to remain upright (sitting or standing) for at least 30 minutes after taking alendronate to prevent esophageal irritation and optimize absorption, reading the morning paper doesn't necessarily ensure the client remains in an upright position. This statement indicates a need for further instruction regarding the importance of post-dose positioning.

C) "I will need to have a bone density test occasionally while taking this medication":
Monitoring bone density periodically is recommended while on alendronate to assess treatment effectiveness and bone health status. This statement shows understanding of the need for ongoing monitoring and does not require further instruction.

D) "I take my other pills at least 30 min after my alendronate,":
Taking other medications at least 30 minutes after alendronate helps to avoid interactions that may reduce its effectiveness. This statement demonstrates correct timing and understanding of medication administration instructions.

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A nurse is assisting in the education of a group of clients about the contraindications of warfarin therapy. Which of the following statements is appropriate to include in the instructions?

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