A nurse is caring for a client who is taking warfarin and reports taking several new herbal supplements. The nurse should identify that which of the following supplements is contraindicated for concurrent use with warfarin?
Ginkgo biloba
Valerian
Coenzyme Q10
Probiotics
The Correct Answer is A
A) Ginkgo biloba: This is the correct answer. Ginkgo biloba is contraindicated for concurrent use with warfarin because it can increase the risk of bleeding due to its anticoagulant properties. It can potentiate the effects of warfarin, leading to an increased risk of bruising and bleeding complications.
B) Valerian: While valerian is an herbal supplement used for its sedative effects, it does not typically interact significantly with warfarin. However, caution should still be exercised when combining valerian with any medication due to its potential to cause drowsiness and enhance the effects of other central nervous system depressants.
C) Coenzyme Q10: Coenzyme Q10 is a dietary supplement that is generally well-tolerated and does not have significant interactions with warfarin. It is often used as an antioxidant and for various cardiovascular conditions.
D) Probiotics: Probiotics are beneficial bacteria that can aid in gut health but are unlikely to interact significantly with warfarin. However, it is essential to monitor for any potential changes in gastrointestinal function when starting probiotics concurrently with warfarin.
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Related Questions
Correct Answer is C
Explanation
A) A child who recently received the human papillomavirus vaccine: There is no contraindication for administering the varicella vaccine to a child who recently received the human papillomavirus vaccine. These vaccines target different viruses and can typically be given concurrently without issue.
B) An older adult client living in a long-term care facility: Older adults living in long-term care facilities are at increased risk of complications from varicella infection and are, therefore, recommended to receive the varicella vaccine unless contraindicated due to specific health conditions.
C) A client who has AIDS: Clients with AIDS or other severe immunosuppressive conditions should not receive live virus vaccines like the varicella vaccine due to the risk of vaccine-induced disease. These individuals may have compromised immune systems, increasing the risk of adverse reactions or inadequate immune response to the vaccine.
D) A young adult who has an allergy to eggs: While some vaccines, including the varicella vaccine, are grown in eggs, having an allergy to eggs is not an absolute contraindication for receiving the vaccine. Most individuals with egg allergies can safely receive the varicella vaccine under medical supervision, as the risk of an allergic reaction is low.
Correct Answer is D
Explanation
A) Black stools: While black stools can be a potential side effect of gastrointestinal bleeding, it is not commonly associated with high-dose metoclopramide. This side effect is more commonly seen with medications such as aspirin or NSAIDs. Therefore, it is not the most pertinent adverse effect to monitor for with high-dose metoclopramide.
B) Dry cough: Dry cough is not a typical adverse effect of metoclopramide. Cough is more commonly associated with medications such as ACE inhibitors. Therefore, it is not the primary adverse effect to monitor for with high-dose metoclopramide.
C) Oral candidiasis: While oral candidiasis (oral thrush) can occur as a side effect of some medications, it is not commonly associated with metoclopramide. Oral candidiasis is more frequently seen with corticosteroids or antibiotics. Therefore, it is not the primary adverse effect to monitor for with high-dose metoclopramide.
D) Tardive dyskinesia: Tardive dyskinesia is a serious adverse effect associated with prolonged use of edicaopramide, especially at high doses. It is characterized by involuntary, repetitive movements of the face, tongue, or other parts of the body. Monitoring for signs and symptoms of tardive dyskinesia, such as repetitive facial grimacing or tongue protrusion, is crucial when administering high-dose metoclopramide to prevent this potentially irreversible condition. Therefore, this is the correct adverse effect to monitor for in clients receiving high-dose metoclopramide.
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