A nurse is preparing a client for discharge home after an admission for bilateral pulmonary emboli. The client is prescribed warfarin in addition to regular daily medications. Which of the following actions should the nurse take?

Consult the pharmacist about potential interactions between the client's regular medications and warfarin.

Tell the client they can continue to drink cranberry juice while taking warfarin.

Recommend the client take warfarin at the same time as other medications.

Advise the client that over-the-counter medications remain safe to consume as needed.

Answer and Explanation

The Correct Answer is A

Rationale:

A. Consult the pharmacist about potential interactions between the client's regular medications and warfarin: Warfarin has numerous drug interactions that can increase bleeding risk or reduce effectiveness. Consulting the pharmacist ensures a thorough review of the client’s medication list for potential harmful interactions before discharge.

B. Tell the client they can continue to drink cranberry juice while taking warfarin: Cranberry juice can potentiate the effects of warfarin and increase bleeding risk by interfering with its metabolism. Clients should be advised to limit or avoid cranberry products.

C. Recommend the client take warfarin at the same time as other medications: Warfarin should be taken at the same time each day, but taking it with other medications may cause interactions. The timing should consider spacing it from medications that might interfere with absorption or potency.

D. Advise the client that over-the-counter medications remain safe to consume as needed: Many OTC medications, especially NSAIDs, can increase bleeding risk when combined with warfarin. Clients need to check with a healthcare provider before taking any new OTC drugs.

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Correct Answer is D

Explanation

Rationale:

A. Compare a list of common medications to treat a condition to the actual prescriptions: This approach does not meet the definition of medication reconciliation, which focuses on comparing the client’s actual prior medications to new orders to prevent errors.

B. Compare the prescription to the allergy history of the client: While this is an important safety check, it is not the primary purpose of medication reconciliation. Allergy review is a separate step done for every prescribed medication, not specifically during reconciliation.

C. Compare the medication label to the provider's prescription on three occasions before administration: This is part of the "three checks" of medication administration to ensure accuracy and safety, but it is unrelated to the reconciliation process that occurs during admission, transfer, or discharge.

D. Compare the client's list of home medications to the admission prescriptions written for the client: This is the central process in medication reconciliation. It ensures continuity of care, prevents omissions, duplications, or interactions, and identifies changes that need clarification.

A. Place the client upright on a donut-shaped cushion. B. Teach the client to shift his weight every 15 min while sitting. C. Assess pressure points every 24 hr. D. Turn and reposition the client every 3 hr while in bed.

Correct Answer is B

Explanation

Rationale:

A. Place the client upright on a donut-shaped cushion: Donut-shaped cushions are not recommended because they create uneven pressure distribution, which can worsen ischemia around pressure points rather than relieve it, potentially delaying healing.

B. Teach the client to shift his weight every 15 min while sitting: Frequent weight shifting relieves pressure on the ischial area and promotes circulation, helping to prevent progression of a stage 1 pressure injury. This intervention supports client independence and tissue integrity.

C. Assess pressure points every 24 hr: Pressure points should be assessed more frequently than once daily, especially in high-risk clients. Routine skin assessments at least once per shift are critical for early detection of pressure injury progression.

D. Turn and reposition the client every 3 hr while in bed: The standard recommendation is to reposition immobile clients at least every 2 hours in bed to redistribute pressure and reduce the risk of further skin breakdown. Extending intervals increases risk of injury.

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A nurse is preparing a client for discharge home after an admission for bilateral pulmonary emboli. The client is prescribed warfarin in addition to regular daily medications. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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