A nurse is reinforcing discharge teaching for a client who will be taking warfarin (Coumadin) at home. Which of the following statements indicates that the client understands the effects of this medication?
"I'll use my electric razor for shaving."
"I'll be sure to eat foods with lots of vitamin K."
"It's okay to have a couple of glasses of wine with dinner."
"I'll take aspirin for my headaches."
The Correct Answer is A
A. "I'll use my electric razor for shaving." This is correct as using an electric razor helps prevent cuts, which is important since warfarin increases bleeding risk.
B. "I'll be sure to eat foods with lots of vitamin K." Vitamin K reduces the effectiveness of warfarin; clients should be consistent with their intake of vitamin K to avoid fluctuations in INR.
C. "It's okay to have a couple of glasses of wine with dinner." Alcohol can increase the effect of warfarin and the risk of bleeding. Clients should avoid or limit alcohol intake.
D. "I'll take aspirin for my headaches." Aspirin also has anticoagulant effects and can increase bleeding risk when taken with warfarin.
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Correct Answer is D
Explanation
A. Creatinine phosphokinase (CPK): CPK levels peak within 24 hours after an MI and return to normal within 2-3 days.
B. Myoglobin: Myoglobin rises within hours but returns to normal within 24 hours after MI.
C. Creatinine kinase-MB (CK-MB): CK-MB peaks 12-24 hours post-MI and returns to baseline within 2-3 days.
D. Troponin T: Troponin T remains elevated for up to 10-14 days after an MI, providing long-term evidence of myocardial injury.
Correct Answer is A
Explanation
A. The ST segment is above the isoelectric line. An elevated ST segment is a hallmark sign of acute myocardial infarction (MI), indicating myocardial injury.
B. The QRS intervals are 0.08 second. A QRS interval of 0.08 seconds is within the normal range and does not indicate myocardial infarction.
C. The QT interval is equal to the R to R interval. QT interval measurements are not diagnostic for acute MI.
D. The PR intervals are 0.15 second. A PR interval of 0.15 seconds is within the normal range and is not indicative of acute MI.