The nurse responds to the client's questions about CAM therapies and explains that some have been popular for centuries in treating conditions of the body and mind including which of the following? (Select All that Apply.)

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.

A. "The anticoagulant effect of a single dose of aspirin can last for as long as a month." This statement is incorrect. While aspirin has antiplatelet effects that inhibit blood clot formation, its duration of action is not as long as a month. Aspirin irreversibly inhibits the enzyme cyclooxygenase (COX), thereby inhibiting platelet aggregation. However, the effects on platelet function are not permanent, and platelets turnover within a few days, thus the anticoagulant effect of a single dose of aspirin typically lasts for a shorter duration.

B. "The anticoagulant effect of a single dose of aspirin can last for as long as a day." Aspirin's primary effect is on platelets, not directly on overall blood clotting. It inhibits the COX enzyme, reducing the production of thromboxane A2, a chemical that promotes platelet aggregation. The initial inhibition of platelet function is strongest within the first 24 hours after taking aspirin. However, the affected platelets remain dysfunctional for their entire lifespan (around 7-10 days).

C. "The anticoagulant effect of a single dose of aspirin can last for as long as a week." This statement is correct. Aspirin's effect on platelets is due to its irreversible inhibition of the COX enzyme. Platelets have a lifespan of about 7-10 days. Once a platelet is affected by aspirin, it cannot regain its function. As your body continuously produces new platelets, the overall antiplatelet effect gradually diminishes over time.

D. "The anticoagulant effect of a single dose of aspirin can last for as long as 12 hours."

Rationale: This statement is partially correct. The antiplatelet effect of aspirin does not typically last as short as 12 hours. While the peak inhibition of platelet function occurs within hours after administration, the duration of action is longer due to the irreversible inhibition of COX-1. However, stating that it lasts exactly 12 hours may not be entirely accurate for all individuals, as the duration of action can vary depending on factors such as individual metabolism and dose.