A nurse is caring for a patient with peripheral arterial disease. Which factor will the nurse identify as the highest risk?

A. Oral candidiasis and nausea: Oral candidiasis (thrush) and nausea are common manifestations in patients with AIDS, particularly when the CD4 count is low. While these symptoms require intervention, they are not typically considered emergent or immediately life-threatening.

B. Genital ulcer and vomiting: Genital ulcers and vomiting can occur in patients with AIDS due to various opportunistic infections and conditions. While these symptoms may warrant intervention, they are not typically indicative of an immediate life-threatening situation.

C. Memory deficit and apathy: Memory deficits and apathy can occur in patients with AIDS, particularly as the disease progresses. While these cognitive and behavioral changes may impact the patient's quality of life and require intervention, they are not typically considered emergent or immediately life-threatening.

D. Progressive dyspnea and fever: Progressive dyspnea (difficulty breathing) and fever are concerning findings in a patient with AIDS, especially with a CD4 count less than 200. These symptoms may indicate the presence of opportunistic infections such as Pneumocystis jirovecii pneumonia (PCP), which can rapidly progress and lead to respiratory failure and death if not promptly treated. Therefore, these assessment findings require immediate intervention to assess for and manage potential respiratory compromise and systemic infection.

A. "I will take this medication at the same time each day": This statement demonstrates an understanding of the importance of consistency in medication administration, which is essential for maintaining therapeutic levels of warfarin in the bloodstream. Therefore, this statement does not indicate a need for further teaching.
B. "I will add a green leafy salad to my dinner today": This statement is concerning because warfarin interacts with vitamin K, which is abundant in green leafy vegetables. Increasing intake of vitamin K-rich foods, such as green leafy salads, can interfere with the anticoagulant effects of warfarin, potentially leading to ineffective treatment. The patient should be educated to maintain a consistent intake of vitamin K-containing foods to avoid fluctuations in warfarin effectiveness.
C. "I will avoid alcohol when I am taking warfarin": This statement demonstrates an understanding of the potential interactions between alcohol and warfarin. Alcohol can increase the risk of bleeding in individuals taking warfarin, so it is advisable to limit or avoid alcohol consumption while on this medication. Therefore, this statement does not indicate a need for further teaching.
D. "I will use an electronic shaver and a soft toothbrush": This statement reflects the patient's understanding of the precautions to minimize the risk of bleeding while taking warfarin. Using an electronic shaver and a soft toothbrush helps reduce the risk of cuts or injuries that could lead to bleeding, especially in individuals whose blood clotting ability may be compromised by warfarin therapy. Therefore, this statement does not indicate a need for further teaching.