A nurse is caring for a client who has been taking warfarin and has a prothrombin time of 30 seconds and an INR of 7. Which of the following medications should the nurse anticipate the provider to prescribe?

A. Have suction equipment at the bedside. Clopidogrel is an antiplatelet medication that inhibits blood clot formation. While it does not typically increase the risk of bleeding to the extent that requires constant suctioning, it's prudent to have suction equipment readily available for any patient who may be at risk of bleeding due to their underlying condition or concurrent medications. However, the administration of clopidogrel alone does not necessitate the need for constant suctioning.

B. Monitor the client for black, tarry stools. This is the correct answer. Clopidogrel, like other antiplatelet medications, increases the risk of bleeding, including gastrointestinal bleeding. Black, tarry stools can indicate gastrointestinal bleeding, which can be a serious complication of clopidogrel therapy. Therefore, monitoring for this symptom is essential for early detection of potential bleeding complications.

C. Administer the medication with each meal. Clopidogrel can be administered with or without food, as it is not significantly affected by food intake. However, there is no specific recommendation to administer it with meals. The timing of administration may vary based on the prescriber's instructions or patient preferences, but it does not need to be consistently administered with meals.

D. Initiate contact precautions. Clopidogrel therapy does not require contact precautions. Contact precautions are typically implemented for patients with contagious infections that spread via direct or indirect contact. Clopidogrel does not pose a risk of transmission to others and does not warrant contact precautions.

A. The client sprinkles flaxseeds on breakfast food every day. Flaxseeds contain omega-3 fatty acids, which can have antithrombotic effects. However, their impact on INR (International Normalized Ratio), the measure of warfarin's anticoagulant effect, is not well-established. While it's important to monitor the client's dietary intake of foods rich in vitamin K or those with potential antithrombotic effects, such as flaxseeds, this is not the priority finding among the options provided.

B. The client keeps a small supply of vitamin K tablets on hand for emergency use. This is the correct answer. Vitamin K is the antidote for warfarin, and the client should not keep a supply of vitamin K tablets on hand for emergency use. Warfarin's anticoagulant effect is carefully monitored through regular INR checks, and adjustments to the dosage are made accordingly. The presence of vitamin K tablets suggests a potential risk of self-adjusting warfarin dosage, which can lead to fluctuations in INR levels and increase the risk of thromboembolic or bleeding events.

C. The client uses garlic as a daily dietary supplement. Garlic is known to have potential antithrombotic effects and can interact with warfarin, increasing the risk of bleeding. However, its impact on INR levels may vary among individuals. While it's important to consider the use of garlic as a dietary supplement, it is not the priority finding among the options provided.

D. The client consistently eats fish for dinner twice weekly. Fish consumption, particularly those rich in omega-3 fatty acids such as salmon or mackerel, can have antithrombotic effects and may affect INR levels. However, the client's consistent fish consumption is less likely to have a significant impact on warfarin therapy compared to the potential self-administration of vitamin K tablets.