The healthcare provider prescribes clopidogrel (Plavix) for a patient at risk for a myocardial infarction. While instructing the patient about the adverse effects and precautions associated with this drug, the nurse tells him that the following drugs should not be used while on clopidogrel unless the doctor is consulted. (Select all that apply.)

A. Constipation: Constipation is not a commonly reported adverse effect of clopidogrel (Plavix). Clopidogrel is an antiplatelet medication that works by inhibiting platelet aggregation, and gastrointestinal effects such as constipation are not typically associated with its use.

B. Bruising: This is a correct answer. Bruising is a known adverse effect of clopidogrel. As an antiplatelet medication, clopidogrel inhibits platelet aggregation, which can increase the risk of bleeding and bruising.

C. Rash: Rash is a potential adverse effect of clopidogrel, although it is not as common as other side effects such as bruising or gastrointestinal symptoms. Patients taking clopidogrel should be monitored for signs of allergic reactions, including rash, which may indicate the need for further evaluation or discontinuation of the medication.

D. Headache: Headache is not a commonly reported adverse effect of clopidogrel. While some patients may experience headache while taking clopidogrel, it is not considered a frequent or significant side effect of the medication.

E. Diarrhea: Diarrhea is not a commonly reported adverse effect of clopidogrel. Gastrointestinal symptoms such as diarrhea are not typically associated with clopidogrel use, although some patients may experience gastrointestinal upset as a side effect of antiplatelet therapy.

A. The client sprinkles flaxseeds on breakfast food every day. Flaxseeds contain omega-3 fatty acids, which can have antithrombotic effects. However, their impact on INR (International Normalized Ratio), the measure of warfarin's anticoagulant effect, is not well-established. While it's important to monitor the client's dietary intake of foods rich in vitamin K or those with potential antithrombotic effects, such as flaxseeds, this is not the priority finding among the options provided.

B. The client keeps a small supply of vitamin K tablets on hand for emergency use. This is the correct answer. Vitamin K is the antidote for warfarin, and the client should not keep a supply of vitamin K tablets on hand for emergency use. Warfarin's anticoagulant effect is carefully monitored through regular INR checks, and adjustments to the dosage are made accordingly. The presence of vitamin K tablets suggests a potential risk of self-adjusting warfarin dosage, which can lead to fluctuations in INR levels and increase the risk of thromboembolic or bleeding events.

C. The client uses garlic as a daily dietary supplement. Garlic is known to have potential antithrombotic effects and can interact with warfarin, increasing the risk of bleeding. However, its impact on INR levels may vary among individuals. While it's important to consider the use of garlic as a dietary supplement, it is not the priority finding among the options provided.

D. The client consistently eats fish for dinner twice weekly. Fish consumption, particularly those rich in omega-3 fatty acids such as salmon or mackerel, can have antithrombotic effects and may affect INR levels. However, the client's consistent fish consumption is less likely to have a significant impact on warfarin therapy compared to the potential self-administration of vitamin K tablets.