Nokea
A nurse is caring for a client prescribed warfarin. The nurse would instruct the client that which of the following foods are high in vitamin K?
- A. Dairy products
- B. Root vegetables
- C. Green leafy vegetables
- D. Fruits and cereals
Correct Answer: C
Rationale: The nurse should inform the client that green leafy vegetables are high in vitamin K, which can affect warfarin's efficacy.
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When describing anticoagulants to a client, which of the following would the nurse expect to include? Select all that apply.
- A. Anticoagulants prevent formation of a thrombus.
- B. Anticoagulants prevent extension of a thrombus.
- C. Anticoagulants dissolve existing thrombi.
- D. Anticoagulants thin the blood.
- E. Anticoagulants can reverse the damage caused by a thrombus.
Correct Answer: A,B
Rationale: Anticoagulants can prevent the formation and extension of a thrombus but have no direct effect on an existing thrombus and do not reverse any of the damage from that thrombus. Although clients often refer to anticoagulants as blood thinners, they do not actually thin the blood.
A client with intermittent claudication is prescribed cilostazol by the primary health care provider. The nurse would expect to administer this drug cautiously if the client's history reveals which of the following?
- A. Intermittent claudication
- B. Pulmonary emboli
- C. Myocardial infarction
- D. Pancytopenia
Correct Answer: D
Rationale: The nurse should administer cilostazol with caution to clients with pancytopenia. Anticoagulants are used for the prevention and treatment of pulmonary emboli, the adjuvant treatment of myocardial infarction, and the treatment of intermittent claudication.
A client in a health care facility is receiving the thrombolytic drug reteplase. Which nursing diagnosis would be most likely?
- A. Anxiety
- B. Constipation
- C. Disturbed Sensory Perception
- D. Ineffective Tissue Perfusion
Correct Answer: A
Rationale: The nursing diagnoses for a client receiving the thrombolytic drug reteplase should include Anxiety, as thrombolytic therapy can be stressful due to its critical nature.
A client is prescribed warfarin. The client also takes a diuretic for the treatment of cardiac problems. The nurse would anticipate which of the following?
- A. Decreased effectiveness of the anticoagulant
- B. Increased effectiveness of the diuretic
- C. Increased absorption of the anticoagulant
- D. Increased absorption of the diuretic
Correct Answer: A
Rationale: The nurse should monitor for decreased effectiveness of warfarin as an effect of the interaction between the anticoagulant and the diuretic.
A female client is prescribed warfarin. The client also uses oral contraceptives. The nurse would assess the client closely for which of the following? Select all that apply.
- A. Bruising
- B. Blood in the stool
- C. Subtherapeutic INR
- D. Supratherapeutic INR
- E. Calf pain and warmth
Correct Answer: C,E
Rationale: Coadministration of warfarin and oral contraceptives can result in a decreased anticoagulant effect, leading to subtherapeutic INR and increased chance of clotting (signs and symptoms of DVT or PE).