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 A
Explanation
A) Incorrect. The client should eat a consistent amount of foods that are high in vitamin K, such as leafy greens, broccoli, and cabbage. Vitamin K can interfere with the anticoagulant effect of warfarin and increase the risk of clotting.
B) Correct. The client should use an electric razor for shaving to prevent cuts and bleeding.
C) Correct. The client should check their blood pressure regularly to monitor for hypertension, which can increase the risk of bleeding complications.
D) Correct. The client should report any signs of bleeding or bruising to their provider, as they may indicate a high INR level or a bleeding disorder.
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.
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