A nurse is caring for a client who has been taking warfarin and has an international normalized ratio (INR) time of 5. Which of the following medications should the nurse anticipate the provider to prescribe?

(A) Decreased stimulation of the sympathetic nervous system (SNS): The sympathetic nervous system (SNS) plays a key role in regulating blood pressure. When the SNS is stimulated, it causes vasoconstriction, or narrowing of the blood vessels, which increases blood pressure. Therefore, decreased stimulation of the SNS would typically lead to vasodilation, or widening of the blood vessels, which would lower blood pressure, not increase it.

(B) Decreased elasticity of blood vessels: As people age, their blood vessels can lose elasticity, which can lead to hypertension. When blood vessels are elastic, they can easily expand and contract with each heartbeat, maintaining a healthy blood pressure. But when they become stiff or rigid, they can’t expand as easily, causing the pressure inside to increase.

(c) Increased peripheral vascular resistance (PVR): Peripheral vascular resistance is the resistance that blood must overcome to flow through the blood vessels. The more resistance, the harder the heart has to work to pump blood through the body, which can lead to increased blood pressure. Factors that can increase PVR include vasoconstriction, or narrowing of the blood vessels, and increased blood viscosity, or thickness.

(D) Decreased fluid volume: Decreased fluid volume, or hypovolemia, would typically lead to a decrease in blood pressure, not an increase. This is because blood pressure is directly related to the volume of blood in the blood vessels. When there’s less blood, the pressure inside the blood vessels is usually lower.

(E) Increased blood viscosity: Blood viscosity refers to the thickness of the blood. When blood is thicker, it’s harder for it to flow through the blood vessels, which increases the resistance to blood flow, leading to increased blood pressure.

A. Review strategies to reduce sodium intake:

This educational method involves providing information and teaching the client specific strategies to reduce sodium intake, such as reading food labels, avoiding high-sodium processed foods, and choosing fresh fruits and vegetables. It engages the cognitive domain of learning as it focuses on acquiring knowledge and understanding of the topic.
B. Ask the client how they are feeling about starting a low sodium diet:

This educational method involves exploring the client's feelings and emotions regarding the low sodium diet. It primarily engages the affective domain of learning, which focuses on attitudes, beliefs, and feelings.
C. Observe the client choose low sodium foods:

This educational method involves observing the client's behavior and actions. It primarily engages the psychomotor domain of learning, which focuses on physical skills and actions.
D. Discuss the physiology of hypertension with the client:

This educational method involves explaining the underlying physiology of hypertension, including factors such as sodium intake, blood pressure regulation, and cardiovascular health. It engages the cognitive domain of learning as it focuses on acquiring knowledge and understanding of the physiological processes involved in hypertension.
E. Encourage the client to share their thoughts in a support group:

This educational method involves providing opportunities for the client to share their thoughts and experiences with others in a support group setting. It primarily engages the affective domain of learning, which focuses on attitudes, beliefs, and feelings.