A nurse is obtaining a medical history from a client who is to start warfarin therapy and currently uses herbal supplements at home. The nurse should inform the client that which of the following herbal supplements can interact adversely with warfarin?

Choice A reason: Grapefruit juice should be avoided while taking verapamil, as it can increase the blood levels of the medication and cause adverse effects such as hypotension, bradycardia, and dizziness. Grapefruit juice inhibits the enzyme that metabolizes verapamil in the liver, leading to higher concentrations of the drug in the bloodstream.

Choice B reason: Orange juice is not a contraindication for verapamil, as it does not affect the metabolism or absorption of the medication. Orange juice is a good source of vitamin C and potassium, which may benefit clients with hypertension.

Choice C reason: Milk is not a contraindication for verapamil, as it does not affect the metabolism or absorption of the medication. Milk is a good source of calcium and protein, which may benefit clients with hypertension.

Choice D reason: Coffee is not a contraindication for verapamil, as it does not affect the metabolism or absorption of the medication. However, coffee contains caffeine, which is a stimulant that can increase the heart rate and blood pressure. Therefore, clients with hypertension should limit their intake of caffeine and other stimulants.

Choice A reason: Weighing the client is not a necessary action before administering digoxin, as it does not affect the dosage or effectiveness of the medication. Weighing the client may be important for monitoring fluid balance and edema, but it is not related to digoxin therapy.

Choice B reason: Measuring the client's blood pressure is not a necessary action before administering digoxin, as it does not affect the dosage or effectiveness of the medication. Digoxin is not a blood pressure-lowering medication, but a cardiac glycoside that increases the contractility and efficiency of the heart. Measuring the blood pressure may be important for monitoring hypertension, but it is not related to digoxin therapy.

Choice C reason: Measuring the client's apical pulse is a necessary action before administering digoxin, as it can help determine the safety and appropriateness of the medication. Digoxin can cause bradycardia (slow heart rate) as a side effect, which can be dangerous and symptomatic. The nurse should check the apical pulse for one full minute and withhold the medication if the pulse is below 60 beats per minute or above 100 beats per minute. The nurse should also report any abnormal or irregular rhythms to the provider.

Choice D reason: Offering the client a light snack is not a necessary action before administering digoxin, as it does not affect the absorption or effectiveness of the medication. Digoxin can be taken with or without food. Offering the client a light snack may be important for maintaining nutrition and hydration, but it is not related to digoxin therapy.