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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. LMWHs produce a more stable effect on coagulation; thus, fewer lab tests are needed: Correct LMWHs have a more predictable anticoagulant response compared to unfractionated heparin, resulting in a more stable effect on coagulation. Because of their predictable response, routine monitoring of coagulation parameters, such as activated partial thromboplastin time (aPTT), is typically not required with LMWH therapy, unlike with unfractionated heparin.
B. LMWHs may be given by the oral route: Incorrect. LMWHs are administered by the subcutaneous route.
C. LMWHs have a short duration of action: Incorrect. LMWHs have a longer duration of action compared to unfractionated heparin.
D. LMWHs possess greater anticoagulant activity: incorrect. LMWHs generally have less potent anticoagulant activity compared to unfractionated heparin, but their more predictable response and longer half-life make them advantageous in many clinical scenario
Correct Answer is D
Explanation
A. Most CAM therapies are not totally ineffective: While some CAM therapies may lack strong scientific evidence, it's not accurate to say they are all ineffective. Some CAM therapies may have benefits, but it's important to be aware of them to avoid interactions.
B. Not all CAM therapies are dangerous: Many CAM therapies are generally safe. However, some can interact with medications or have unforeseen side effects, so assessing use is crucial.
C. Additional treatment may still be needed: Even if a patient uses CAM, they might still require conventional medical treatment. Assessing CAM use helps ensure a complete picture of the patient's healthcare regimen.
D. CAM therapies could interact with prescription and OTC medications. Correct. The primary reason to assess CAM use is to identify potential interactions with medications, potentially improving patient safety and treatment effectiveness.
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