A nurse is collecting data from a client who has a prosthetic aortic valve and takes warfarin daily at bedtime. Which of the following data is the priority finding for the nurse to report to the provider?

The client sprinkles flaxseeds on breakfast food every day.

The client keeps a small supply of vitamin K tablets on hand for emergency use.

The client uses garlic as a daily dietary supplement.

The client consistently eats fish for dinner twice weekly.

Answer and Explanation

The Correct Answer is B

A. The client sprinkles flaxseeds on breakfast food every day. Flaxseeds contain omega-3 fatty acids, which can have antithrombotic effects. However, their impact on INR (International Normalized Ratio), the measure of warfarin's anticoagulant effect, is not well-established. While it's important to monitor the client's dietary intake of foods rich in vitamin K or those with potential antithrombotic effects, such as flaxseeds, this is not the priority finding among the options provided.

B. The client keeps a small supply of vitamin K tablets on hand for emergency use. This is the correct answer. Vitamin K is the antidote for warfarin, and the client should not keep a supply of vitamin K tablets on hand for emergency use. Warfarin's anticoagulant effect is carefully monitored through regular INR checks, and adjustments to the dosage are made accordingly. The presence of vitamin K tablets suggests a potential risk of self-adjusting warfarin dosage, which can lead to fluctuations in INR levels and increase the risk of thromboembolic or bleeding events.

C. The client uses garlic as a daily dietary supplement. Garlic is known to have potential antithrombotic effects and can interact with warfarin, increasing the risk of bleeding. However, its impact on INR levels may vary among individuals. While it's important to consider the use of garlic as a dietary supplement, it is not the priority finding among the options provided.

D. The client consistently eats fish for dinner twice weekly. Fish consumption, particularly those rich in omega-3 fatty acids such as salmon or mackerel, can have antithrombotic effects and may affect INR levels. However, the client's consistent fish consumption is less likely to have a significant impact on warfarin therapy compared to the potential self-administration of vitamin K tablets.

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Correct Answer is D

Explanation

A. May improve cardiac function: This statement avoids claiming to diagnose, treat, cure, or prevent disease. It uses general language about supporting heart health, which is permissible.

B. May reduce pain and inflammation: Similar to option A, this statement avoids disease claims and uses general terms about pain and inflammation, which is allowed.

C. Helps promote a healthy immune system: This follows the same principle. It avoids disease claims and uses general language regarding the immune system.

D. Reduces blood pressure and the risk for stroke: This statement specifically mentions a disease (stroke) and claims to reduce its risk. Dietary supplement labels are not allowed to make disease claims. They can only make general claims about supporting bodily functions.

A. Vitamin K B. Deferoxamine C. Acetylcysteine D. Protamine sulfate

Correct Answer is D

Explanation

A. Vitamin K: Vitamin K is the antidote for warfarin, not heparin. Warfarin works by inhibiting the synthesis of vitamin K-dependent clotting factors in the liver. Therefore, vitamin K is used to reverse the effects of warfarin in cases of over-anticoagulation. It does not reverse the effects of heparin.

B. Deferoxamine: Deferoxamine is a chelating agent used to treat iron toxicity and aluminum overload. It is not indicated for reversing the effects of heparin.

C. Acetylcysteine: Acetylcysteine is used as an antidote for acetaminophen (paracetamol) overdose. It is not indicated for reversing the effects of heparin.

D. Protamine sulfate: This is the correct answer. Protamine sulfate is the antidote for heparin. It works by binding to heparin to form a stable complex, thereby neutralizing its anticoagulant effects. Protamine sulfate is commonly used in clinical practice to reverse the effects of heparin in situations such as hemorrhage or when rapid reversal of anticoagulation is needed, such as before surgery.

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A nurse is collecting data from a client who has a prosthetic aortic valve and takes warfarin daily at bedtime. Which of the following data is the priority finding for the nurse to report to the provider?

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