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 B

Explanation

Rationale:

A. Troponin level: Troponin is a cardiac biomarker used to detect myocardial injury or infarction. It is not an indicator of nutritional status and does not reflect protein levels or nutrient balance.

B. Serum albumin: Albumin is a plasma protein synthesized in the liver and commonly used as a marker of long-term nutritional status. Low levels may suggest protein-energy malnutrition or chronic illness affecting nutrient absorption or intake.

C. Erythrocyte sedimentation rate: ESR is a nonspecific marker of inflammation or infection. While chronic disease can indirectly affect nutrition, ESR does not directly assess nutrient levels or dietary sufficiency.

D. Serum sodium: Sodium levels reflect fluid balance and electrolyte status but are not indicators of nutritional status. They may be influenced by hydration, renal function, or hormonal imbalances, not by dietary protein intake.

A. Auscultation B. Inspection C. Palpation D. Percussion

Correct Answer is C

Explanation

Rationale:

A. Auscultation: This step is performed after inspection and before percussion or palpation to avoid altering bowel sounds. It allows the nurse to assess for the presence, frequency, and character of bowel sounds without stimulating them artificially.

B. Inspection: This is the first step in the abdominal assessment. It involves visually examining the abdomen for contour, symmetry, skin changes, pulsations, or visible masses without touching the patient, helping establish a baseline.

C. Palpation: Palpation is the final step in abdominal assessment to prevent interference with bowel sounds. It allows the nurse to detect tenderness, masses, or organ enlargement, but should only be done after auscultation and percussion.

D. Percussion: This is done after auscultation and provides information on underlying structures, such as gas, fluid, or masses. It helps differentiate between dullness, resonance, or tympany across abdominal quadrants.

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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?

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