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.
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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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
A. If he misses a dose, he should double the dose at the next scheduled time: This statement is incorrect. Doubling the dose of warfarin after missing a dose can significantly increase the risk of bleeding due to excessive anticoagulation. The nurse should emphasize the importance of taking the medication as prescribed and what to do if a dose is missed, such as contacting the healthcare provider for guidance.
B. The client should use an electric razor while on this medication: This statement is correct. Warfarin is an anticoagulant medication that can increase the risk of bleeding. Therefore, it's essential for patients taking warfarin to avoid activities that may increase the risk of injury or bleeding, such as shaving with a traditional razor that can cause cuts or nicks. Using an electric razor reduces this risk.
C. Mild nosebleeds are common during initial treatment: This statement is not entirely accurate. While warfarin can increase the risk of bleeding, including nosebleeds, it's not necessarily common during the initial treatment phase. However, patients should be aware of signs of bleeding and report them to their healthcare provider promptly.
D. Warfarin increases the risk for deep vein thrombosis: This statement is incorrect. Warfarin is actually prescribed to reduce the risk of blood clots, including deep vein thrombosis (DVT), pulmonary embolism (PE), and stroke, in patients who are at risk for these conditions. It works by inhibiting the formation of blood clots. Therefore, it does not increase the risk of DVT; rather, it decreases it.
Correct Answer is C
Explanation
- White Blood Cell Count (WBC): WBCs are part of the immune system and play a role in fighting infections. However, they are not directly involved in hemostasis or clot formation. WBCs do not adhere to the vessel wall during hemostasis.
- Activated Partial Thromboplastin Time (aPTT): aPTT measures the time it takes for blood to clot. It is primarily used to monitor heparin therapy, not warfarin. aPTT is not specific for warfarin monitoring.
- Prothrombin Time (PT): PT measures how quickly blood clots. It is used to monitor warfarin therapy and assess clotting factors. PT is essential for monitoring warfarin effectiveness.
- Platelet Count: Platelets are crucial for clot formation. Platelet count helps assess platelet function. Platelets play a direct role in hemostasis.
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