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 B
Explanation
A. Enriched cereal in whole milk. Whole milk is high in saturated fats, which the DASH diet aims to limit.
B. Turkey sandwich on whole wheat bread, green beans, and banana. This meal is balanced, low in saturated fats, high in fiber, and aligns well with the DASH diet principles.
C. Pork sausage and baked beans. Pork sausage is high in saturated fats and sodium, which should be limited in the DASH diet.
D. Hamburger, steak fries, and an orange. While the orange is DASH-friendly, the hamburger and fries are high in fats and sodium.
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.