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 A

Explanation

A. Labeling is not always reliable and herbal products should be used with caution. Herbal products are not subject to the same rigorous regulations and testing as pharmaceutical drugs. Therefore, their labeling may not always be accurate or comprehensive. Patients need to be aware of potential risks, interactions, and variations in potency associated with herbal products. Education helps patients make informed decisions and use these products safely.

B. Herbal products are approved under strict FDA regulations. This statement is false. Unlike pharmaceutical drugs, herbal products are regulated as dietary supplements in the United States and are not subject to the same level of scrutiny and approval processes by the FDA. While the FDA regulates the manufacturing and labeling of dietary supplements, including herbal products, the standards are not as strict as those for prescription or over-the-counter medications.

C. There are so few side effects, and they can be purchased without a prescription. This statement is misleading and potentially dangerous. Herbal products can indeed have side effects and interactions with medications, and their safety profiles vary widely. Additionally, the availability of herbal products without a prescription does not necessarily imply safety. Patients need education to understand potential risks and benefits associated with herbal product use.

D. The manufacturer has repeatedly demonstrated effectiveness. This statement is unsubstantiated and may not be true for all herbal products. Unlike pharmaceutical drugs, herbal products often lack extensive scientific evidence supporting their effectiveness for specific indications. While some manufacturers may conduct studies to support their products' efficacy, the evidence may be limited or inconclusive. Patients need education to critically evaluate claims of effectiveness and make informed decisions about herbal product use.

A. check with a reputable pharmacist B. take less than the recommended dose initially C. use only one herbal preparation at a time D. never take with prescription medications

Correct Answer is B

Explanation

A. Check with a reputable pharmacist: This option is a good practice, especially when starting any new medication or supplement regimen. Pharmacists are trained to understand drug interactions and potential adverse effects. They can provide valuable information about herbal products, their interactions with prescription medications, and potential allergic reactions. However, it might not be the best way to identify allergic reactions firsthand.

B. Take less than the recommended dose initially: This approach, known as dose titration, can be beneficial for identifying potential adverse reactions, including allergies. By starting with a smaller dose, the client can gauge their body's response to the herbal product. If there's any adverse reaction, it's likely to be less severe than if they took a full dose. This option allows for a controlled introduction to the herbal product. This option allows for a controlled introduction to the herbal product, minimizing the risk of severe adverse reactions while still providing valuable information about the client's tolerance and potential allergies.

C. Use only one herbal preparation at a time: This is a prudent approach because it simplifies the process of identifying the cause of any adverse reactions. If the client is using multiple herbal products simultaneously and experiences a reaction, it can be challenging to determine which product is responsible. Using only one product at a time helps isolate the source of any adverse effects, making it easier to identify allergies or other reactions.

D. Never take with prescription medications: This option is not entirely accurate. While it's essential to be cautious about potential interactions between herbal products and prescription medications, there are instances where they can be safely taken together. However, it's crucial to consult with a healthcare provider or pharmacist to ensure there are no contraindications or adverse effects when combining herbal products with prescription medications.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

It is important that nurses ensure that their patients receive education regarding herbal products because:

Correct Answer is A

Explanation

When beginning herbal products, the nurse understands that the best way to identify allergic or other adverse reactions is to have the client:

Correct Answer is B

Explanation

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