A nurse is reviewing the medical history of a client who asks about the use of warfarin.
The nurse should identify which of the following findings as a contraindication for the administration of this medication?

Recent myocardial infarction.

Recent eye surgery.

Thrombophlebitis.

Breast cancer.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Recent myocardial infarction is not a contraindication for warfarin administration. Warfarin is often prescribed for patients with a history of myocardial infarction to prevent clot formation and reduce the risk of stroke.

Choice B rationale:

Recent eye surgery is a contraindication for the administration of warfarin. Warfarin can increase the risk of bleeding, which is particularly concerning after eye surgery due to the delicate nature of ocular tissues. Using anticoagulants in this scenario can lead to severe complications, including vision loss.

Choice C rationale:

Thrombophlebitis, inflammation of a vein with clot formation, is not a contraindication for warfarin administration. In fact, anticoagulants like warfarin are commonly prescribed to prevent the extension of clots and reduce the risk of complications associated with thrombophlebitis.

Choice D rationale:

Breast cancer is not a direct contraindication for warfarin administration. However, the decision to use anticoagulants in patients with a history of breast cancer should be made carefully, considering individual factors such as the stage of cancer, ongoing treatment, and overall risk of thromboembolic events.

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Correct Answer is A

Explanation

A. A client who received a Mantoux test 48 hr ago and has an induration. B. A client who is taking warfarin and has an INR of 1.8. C. A client who is scheduled for a colonoscopy and is taking sodium phosphate. D. A client who is taking bumetanide and has a potassium level of 3.6 mEq/L.

Correct Answer is B

Explanation

Choice A rationale:

A client who received a Mantoux test 48 hr ago and has an induration does not require immediate follow-up care. An induration at the injection site indicates a positive reaction, but further evaluation and management are necessary, not urgent.

Choice B rationale:

A client taking warfarin with an INR of 1.8 requires follow-up care. The normal range for INR in a client taking warfarin is usually 2.0 to 3.0. An INR of 1.8 suggests inadequate anticoagulation, putting the client at risk of thromboembolic events. Dose adjustment or other interventions are needed to bring the INR within the therapeutic range.

Choice C rationale:

A client scheduled for a colonoscopy and taking sodium phosphate does not necessarily require immediate follow-up care. However, sodium phosphate can cause electrolyte imbalances, so monitoring for any signs of electrolyte disturbances is essential, but it does not mandate urgent intervention.

Choice D rationale:

A client taking bumetanide with a potassium level of 3.6 mEq/L requires follow-up care. The normal range for potassium is typically 3.5 to 5.0 mEq/L. A potassium level below the normal range (hypokalemia) can lead to cardiac arrhythmias and muscle weakness. The client may need potassium supplements or dietary adjustments to correct the imbalance.

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A nurse is reviewing the medical history of a client who asks about the use of warfarin.The nurse should identify which of the following findings as a contraindication for the administration of this medication?

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A nurse is reviewing the medical history of a client who asks about the use of warfarin.
The nurse should identify which of the following findings as a contraindication for the administration of this medication?