A nurse is caring for a patient who is taking warfarin (Coumadin). Which of the following laboratory values should the nurse monitor regularly?

This statement indicates a need for further teaching because aspirin is an antiplatelet drug that can increase the risk of bleeding when taken with warfarin (Coumadin), an anticoagulant.The patient should avoid aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) and use acetaminophen (Tylenol) or other pain relievers that do not affect blood clotting.

Choice A is wrong because it is a correct statement.The patient should avoid activities that could cause injury, such as contact sports, shaving with a razor, or using sharp objects, because they could lead to bleeding complications while on warfarin (Coumadin).

Choice C is wrong because it is a correct statement.The patient should report any unusual bleeding to their healthcare provider, such as nosebleeds, easy bruising, blood in urine or stool, heavy menstrual bleeding, or bleeding gums.

These could be signs of excessive anticoagulation or adverse effects of warfarin (Coumadin).

Choice D is wrong because it is a correct statement.The patient should use a soft-bristled toothbrush and floss gently to prevent gum bleeding while on warfarin (Coumadin).The patient should also avoid dental procedures without consulting their healthcare provider first.

The normal range for INR (international normalized ratio), a test that measures how long it takes blood to clot, is 0.75-1.25 for people who are not taking warfarin (Coumadin).For people who are taking warfarin (Coumadin), the therapeutic range is usually 2-3, depending on the condition being treated.The patient’s INR level should be monitored regularly to adjust the dose of warfarin (Coumadin) and prevent bleeding or clotting complications.

This statement indicates a need for further teaching because taking an antacid can interfere with the absorption of warfarin and affect its effectiveness. The client should not self-medicate with any over-the-counter drugs without consulting their healthcare provider first.

Choice A is wrong because reporting black tarry stools and abdominal pain to the healthcare provider immediately is the appropriate action.These symptoms may indicate gastrointestinal bleeding, which is a serious adverse effect of warfarin.

Choice B is wrong because stopping the medication if these symptoms persist is not advisable.Warfarin should not be discontinued abruptly without medical supervision, as this can increase the risk of thrombosis.

Choice D is wrong because increasing the intake of green leafy vegetables is not harmful.

Green leafy vegetables are rich in vitamin K, which is the antidote for warfarin overdose.However, the client should maintain a consistent intake of vitamin K and avoid sudden changes in their diet.