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 A
Explanation
A. "Cardiac rehabilitation cannot undo the damage to your heart, but it can help you get back to your previous level of activity safely." This response is therapeutic and educative, helping the client understand that while damage cannot be reversed, rehabilitation supports safe recovery and improved quality of life.
B. "Your doctor is the expert here, and I'm sure he would only recommend what is best for you." This response does not address the client’s concerns and lacks supportive or educational value.
C. "You are probably right and I agree with you, but I still think you should go." This dismissive response fails to provide support, education, or empathy.
D. "It's not unusual to feel that way at first, but once you learn the routine, you'll be fine." Although this statement offers some support, it lacks the educational element needed to address the client’s concerns about the purpose of rehabilitation.
Correct Answer is A
Explanation
A. Shortness of breath while lying down. Shortness of breath when lying down, or orthopnea, is common in left-sided heart failure due to fluid backing up into the lungs, causing pulmonary congestion.
B. Jugular venous distention. Jugular venous distention is more commonly associated with right-sided heart failure due to systemic venous congestion.
C. Right upper quadrant pain. Right upper quadrant pain is associated with liver congestion due to right-sided heart failure, not left-sided heart failure.
D. Pitting edema of the lower legs. Pitting edema is a symptom of right-sided heart failure, as fluid backs up into the peripheral circulation.