A nurse is caring for a patient who has been prescribed apixaban (Eliquis) for deep vein thrombosis (DVT). Which instructions should be included in patient teaching? Select all that apply.

“Avoid activities that may cause injury.”

“Take medication with food.”

“Report signs and symptoms of bleeding immediately.”

“Monitor vital signs regularly.”

“Do not take aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs).”.

Answer and Explanation

Correct Answer : A,C,E

Apixaban (Eliquis) is a blood thinner that prevents blood clots from forming or growing larger.

It is used to treat or prevent deep vein thrombosis (DVT), a condition in which a blood clot forms in a vein deep in the body, usually in the legs.

It can also prevent pulmonary embolism (PE), a condition in which a blood clot breaks off and travels to the lungs, blocking blood flow and causing breathing problems.

Patients taking apixaban should follow these instructions:

• Avoid activities that may cause injury.

Apixaban can increase the risk of bleeding, so patients should be careful not to cut or bruise themselves.

They should use a soft toothbrush, an electric razor, and avoid contact sports or other activities that may cause bleeding. They should also wear a medical alert bracelet or carry an identification card that states they are taking apixaban.

• Report signs and symptoms of bleeding immediately. Patients should notify their doctor or seek emergency care if they have any signs of bleeding, such as unusual bruising, red or black stools, blood in the urine, coughing up blood, vomiting blood, nosebleeds, heavy menstrual bleeding, headaches, dizziness, weakness, or swelling.

• Do not take aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs).

These drugs can also increase the risk of bleeding and interfere with the effects of apixaban.

Patients should avoid taking aspirin, ibuprofen, naproxen, or other NSAIDs unless prescribed by their doctor. They should also check the labels of any over-the-counter medications or supplements they use and avoid those that contain aspirin or NSAIDs.

Choice B and D are wrong because:

• Take medication with food. Apixaban can be taken with or without food. Taking it with food does not affect its absorption or efficacy.

Therefore, this instruction is not necessary for patients taking apixaban.

• Monitor vital signs regularly. Apixaban does not affect blood pressure, heart rate, or oxygen saturation.

Therefore, monitoring vital signs regularly is not required for patients taking apixaban. However, patients should still follow their doctor’s advice on how often to check their blood tests, such as hemoglobin, hematocrit, and platelets.

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Correct Answer is ["A","C","D"]

Explanation

Warfarin (Coumadin) is a blood thinner that prevents blood clots from forming or growing larger.

It is used to treat or prevent deep vein thrombosis (DVT), a condition in which a blood clot forms in a vein deep in the body, usually in the legs.

It can also prevent pulmonary embolism (PE), a condition in which a blood clot breaks off and travels to the lungs, blocking blood flow and causing breathing problems.

Patients taking warfarin should follow these instructions:

• Avoid foods that are high in vitamin K.

Vitamin K is needed for the production of some clotting factors in the liver.

Warfarin blocks the action of vitamin K, and thus reduces the clotting ability of the blood.

However, if the intake of vitamin K varies significantly from day to day, it can affect the stability of the warfarin effect.Foods that are high in vitamin K include green leafy vegetables, such as spinach, kale, broccoli, cabbage, and lettuce, as well as some vegetable oils, such as soybean and canola.Patients should not avoid these foods completely, but they should keep their intake consistent and inform their doctor or pharmacist if they make any changes to their diet.

• Report any unusual bleeding to healthcare provider.

Warfarin can increase the risk of bleeding, especially if the dose is too high or if it interacts with other medications or supplements.Patients should notify their doctor or seek emergency care if they have any signs of bleeding, such as bruising, red or black stools, blood in the urine, coughing up blood, vomiting blood, nosebleeds, heavy menstrual bleeding, headaches, dizziness, weakness, or swelling.They should also inform their doctor of any other medications or supplements they are taking, including over-the-counter products and herbal remedies.

• Use an electric razor when shaving.

Warfarin can make the skin more prone to bleeding from minor cuts or injuries.

Patients should use an electric razor when shaving to reduce the risk of nicking themselves and causing bleeding.They should also use a soft toothbrush and avoid flossing if it causes bleeding.They should wear gloves when handling sharp objects or working in the garden.

Choice B and E are wrong because:

• Take aspirin for pain relief.

Aspirin is a medication that also prevents blood clots by inhibiting platelets, which are cells that stick together to form clots.Taking aspirin with warfarin can increase the risk of bleeding significantly and is not recommended unless prescribed by a doctor for a specific reason.Patients should avoid taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, for pain relief unless advised by their doctor.They should also check the labels of any over-the-counter medications or supplements they use and avoid those that contain aspirin or NSAIDs.

• Wear shoes that fit well and avoid tight clothing.

This instruction is not related to warfarin therapy and does not affect its efficacy or safety.

However, it may be a general advice for patients with DVT to prevent further complications or discomfort.Wearing shoes that fit well and avoiding tight clothing can help improve blood circulation in the legs and prevent swelling or pain.Patients with DVT should also elevate their legs when possible and wear compression stockings if prescribed by their doctor.

A. Ibuprofen B. Naproxen C. Acetaminophen D. Aspirin.

Correct Answer is C

Explanation

The patient reports having frequent headaches and asks for an over-the-counter pain reliever.The nurse will recommend acetaminophen, which is the safest pain reliever while taking warfarin.Acetaminophen does not interfere with the anticoagulant effect of warfarin and does not increase the risk of bleeding.

Choice A is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can enhance the anticoagulant effect of warfarin and increase the likelihood of harmful bleeding.

NSAIDs can also cause stomach ulcers, kidney damage, and high blood pressure.

Choice B is wrong because naproxen is another NSAID that has the same risks as ibuprofen.

Naproxen should be avoided by patients taking warfarin.

Choice D is wrong because aspirin is also an anticoagulant that can increase the risk of bleeding when taken with warfarin.

Aspirin can also cause stomach irritation, ulcers, and allergic reactions.

The normal range for INR is 2 to 3 for patients with atrial fibrillation who are taking warfarin.

An INR of 2.5 indicates that the patient’s blood is taking longer to clot than normal, but not too long.

The patient should have regular blood tests to monitor their INR and adjust their warfarin dose if needed.

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A nurse is caring for a patient who has been prescribed apixaban (Eliquis) for deep vein thrombosis (DVT). Which instructions should be included in patient teaching? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client has been prescribed warfarin (Coumadin) for treatment of deep vein thrombosis (DVT). Which of the following instructions should the nurse include in patient teaching? Select all that apply.

Correct Answer is ["A","C","D"]

Explanation

A patient who has atrial fibrillation is taking warfarin and has an INR of 2.5.The patient reports having frequent headaches and asks for an over-the-counter pain reliever.The nurse will recommend which medication?

Correct Answer is C

Explanation

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