A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following statements by the client indicates an understanding of the teaching?
"I will use an electric razor when shaving."
"I will eat more green leafy vegetables to prevent bleeding."
"I will take an extra dose if I miss one."
"I will check my blood pressure every day."
The Correct Answer is A
A) Correct. The client should use an electric razor when shaving to reduce the risk of bleeding from minor cuts or nicks. Warfarin is an anticoagulant that inhibits blood clotting and increases the bleeding time.
B) Incorrect. The client should not eat more green leafy vegetables to prevent bleeding. Green leafy vegetables are high in vitamin K, which antagonizes the effect of warfarin and reduces its anticoagulant activity.
C) Incorrect. The client should not take an extra dose if they miss one. Taking an extra dose can cause excessive anticoagulation and increase the risk of bleeding or hemorrhage.
D) Incorrect. The client should not check their blood pressure every day unless instructed by their health care provider. Checking blood pressure every day is not related to warfarin therapy and may cause unnecessary anxiety or confusion.
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Related Questions
Correct Answer is B
Explanation
A) Incorrect. The nurse should not instruct the client to stop taking both medications immediately without consulting the client's primary care provider. Abruptly discontinuing some medications can cause adverse effects or withdrawal symptoms.
B) Correct. The nurse should assess the client for signs of gastrointestinal bleeding, such as abdominal pain, black or tarry stools, or coffee-ground emesis. Ibuprofen and naproxen are both nonsteroidal anti-inflammatory drugs (NSAIDs) that can increase the risk of gastrointestinal bleeding when taken together or for a long time.
C) Incorrect. The nurse should document the finding in the client's medical record after assessing the client and notifying the primary care provider. Documentation is an important but not a priority action in this situation.
D) Incorrect. The nurse should notify the client's primary care provider after assessing the client for signs of gastrointestinal bleeding. The primary care provider may need to adjust or change the client's medication regimen to prevent further complications.
Correct Answer is D
Explanation
A) Incorrect. The nurse should instruct the client to store unopened insulin vials in the refrigerator, not in the freezer. Freezing can damage the insulin and make it ineffective.
B) Correct. The nurse should instruct the client to rotate injection sites within the same anatomical region, such as the abdomen, thighs, arms, or buttocks. Rotating injection sites can prevent lipodystrophy, which is a disorder of fat metabolism that causes hypertrophy or atrophy of subcutaneous tissue.
C) Incorrect. The nurse should instruct the client not to mix short-acting and long-acting insulins in the same syringe. Mixing different types of insulins can alter their onset, peak, and duration of action and affect blood glucose control.
D) Correct. The nurse should instruct the client to draw up regular insulin before NPH insulin when mixing them in the same syringe. This can prevent contamination of the regular insulin vial with NPH insulin, which can affect its potency and clarity.
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