A nurse is teaching a client who has been prescribed warfarin for atrial fibrillation. Which of the following statements by the client indicates a need for further education?
"I will avoid eating foods that are high in vitamin K."
"I will use a soft-bristled toothbrush to prevent bleeding."
"I will monitor my blood pressure regularly at home."
"I will report any signs of bruising or bleeding to my provider."
The Correct Answer is A
A) Incorrect. The client should not avoid eating foods that are high in vitamin K, such as leafy green vegetables, because they can interfere with the anticoagulant effect of warfarin. The client should maintain a consistent intake of vitamin K and follow a balanced diet.
B) Correct. The client should use a soft-bristled toothbrush to prevent bleeding from the gums, which can occur due to the increased risk of bleeding caused by warfarin. The client should also avoid using dental floss and electric razors.
C) Correct. The client should monitor their blood pressure regularly at home, as warfarin can affect blood pressure and increase the risk of stroke or bleeding complications. The client should report any abnormal readings to their provider.
D) Correct. The client should report any signs of bruising or bleeding to their provider, as they may indicate an adverse reaction to warfarin or an overdose. The client should also report any signs of infection, such as fever, sore throat, or pus, as they may increase the risk of bleeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Incorrect. Acetaminophen is a non-opioid analgesic that can be used safely with phenytoin. However, the nurse should advise the client to limit their intake of acetaminophen to no more than 4 g per day, as higher doses can cause liver toxicity.
B) Incorrect. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can be used safely with phenytoin. However, the nurse should advise the client to monitor for signs of bleeding, such as bruising, petechiae, and hematuria, as NSAIDs can inhibit platelet aggregation and increase the risk of bleeding.
C) Incorrect. Diphenhydramine is an antihistamine that can be used safely with phenytoin. However, the nurse should advise the client to avoid driving or operating machinery while taking diphenhydramine, as it can cause drowsiness and impair mental alertness.
D) Correct. Ginkgo biloba is an herbal supplement that can interact with phenytoin and reduce its effectiveness. Ginkgo biloba can induce hepatic enzymes that increase the metabolism and clearance of phenytoin, leading to subtherapeutic levels and increased risk of seizures.
Correct Answer is B
Explanation
A) Incorrect. Morphine sulfate does not need to be diluted in normal saline before administration. Diluting the medication can reduce its potency and effectiveness.
B) Correct. Morphine sulfate should be injected slowly over 1 to 2 minutes to prevent adverse effects, such as hypotension, respiratory depression, and nausea.
C) Incorrect. Heparin is not indicated for flushing the IV line before and after administration of morphine sulfate. Heparin is an anticoagulant that can increase the risk of bleeding. The IV line should be flushed with normal saline or sterile water to prevent medication incompatibility and ensure complete delivery of the medication.
D) Incorrect. The nurse should monitor the client's respiratory rate more frequently than every 15 minutes, as morphine sulfate can cause respiratory depression. The nurse should monitor the client's respiratory rate before, during, and after administration of the medication, and at least every 5 minutes until the client's pain is relieved.
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