A nurse is discussing intravenous Amphotericin B treatment with a nursing student who is about to care for a patient with a systemic fungal infection. Which statement by the student indicates a need for further teaching?

Choice C reason: Abdominal distention and hypogastric pain are classic signs and symptoms of large bowel obstruction. The obstruction prevents the normal passage of intestinal contents, leading to a buildup of gas and fluid, which causes distention and pain.
Choice A reason: Epigastric pain and rectal bleeding are not typical signs of large bowel obstruction. These symptoms are more commonly associated with other gastrointestinal conditions, such as peptic ulcers or colorectal cancer.
Choice B reason: Fluid overload and passing gas are not characteristic of large bowel obstruction. In fact, the inability to pass gas is a common symptom of bowel obstruction.
Choice D reason: Diarrhea and excessive thirst are not typical signs of large bowel obstruction. Diarrhea is more commonly associated with conditions affecting the small intestine or infections, while excessive thirst is a symptom of dehydration or diabetes.

Choice A reason:
The onset of warfarin is delayed, meaning it takes longer to achieve a therapeutic effect. Warfarin requires several days to adjust to effective anticoagulation levels because it works by inhibiting the synthesis of clotting factors that are already present and active in the bloodstream. In contrast, heparin has an immediate anticoagulant effect when administered, which is crucial for patients with acute conditions like deep vein thrombosis.

Choice B reason:
Warfarin does not prevent platelet aggregation. Instead, it works by inhibiting vitamin K-dependent clotting factors, which are essential for blood coagulation. Platelet aggregation is primarily inhibited by antiplatelet drugs like aspirin or clopidogrel, not anticoagulants like warfarin.

Choice C reason:
Heparin does not necessarily have fewer adverse effects compared to warfarin. Both anticoagulants have their specific risks and side effects. Heparin is preferred in acute settings due to its rapid onset of action, but it can cause complications like heparin-induced thrombocytopenia (HIT), which requires careful monitoring.

Choice D reason:
Heparin does not have a longer half-life than warfarin. In fact, heparin's half-life is relatively short, which is why it is often administered via continuous infusion or frequent subcutaneous injections. Warfarin has a longer half-life, but its delayed onset of action makes it less suitable for immediate anticoagulation needs.