A nurse is reviewing the medication list for a client who has a new prescription for warfarin. The nurse should recognize which is incompatible with warfarin?
Vitamin A
Alprazolam
Vitamin K
Furosemide
The Correct Answer is C
A) Vitamin A: While vitamin A can affect various bodily functions, it is not known to have a direct interaction with warfarin. Therefore, it is not considered incompatible with warfarin therapy.
B) Alprazolam: This medication, a benzodiazepine, is primarily used to treat anxiety and does not have a significant interaction with warfarin. Thus, it is not incompatible with warfarin therapy.
C) Vitamin K: This vitamin is a critical consideration when a client is on warfarin therapy. Warfarin works by inhibiting vitamin K-dependent clotting factors, so an increased intake of vitamin K can counteract the effects of warfarin, making this the correct answer. Clients on warfarin should maintain a consistent intake of vitamin K to prevent fluctuations in their INR levels.
D) Furosemide: This loop diuretic is used to manage conditions such as heart failure and edema. While it may affect electrolyte levels, it does not have a direct interaction that would render it incompatible with warfarin. It can be safely used alongside warfarin with appropriate monitoring.
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Correct Answer is ["A","B","C","D"]
Explanation
A) "I will apply my compression stockings." Compression stockings are a standard recommendation for clients with peripheral venous disease (PVD). They help improve venous return and reduce symptoms like swelling and discomfort, indicating that the client understands the importance of managing their condition.
B) "I will limit long periods of standing." This statement reflects an understanding of the need to avoid activities that can exacerbate venous stasis and contribute to worsening symptoms in PVD. Limiting long periods of standing helps promote better blood flow and reduces the risk of complications.
C) "I may develop a brownish discoloration to my lower extremities." This statement indicates an awareness of a potential complication of PVD, often caused by venous stasis and pooling of blood. Brownish discoloration, or stasis dermatitis, can occur in the lower extremities, showing the client’s understanding of the condition.
D) "With this problem, I may have lower extremity hair loss." This statement is accurate as well; hair loss on the lower extremities can occur with PVD due to reduced blood flow and oxygen supply to the tissues. This recognition indicates that the client understands the potential effects of their diagnosis.
E) "I will only take my cholesterol lowering medication every other day in the afternoon." This statement reflects a misunderstanding of medication management. Clients with PVD should take prescribed medications as directed to manage their condition effectively, and altering the dosing schedule without consulting a healthcare provider can lead to adverse outcomes.
Correct Answer is C
Explanation
A) Intermittent claudication: This symptom is indicative of arterial insufficiency, not chronic venous insufficiency. Intermittent claudication is characterized by pain in the legs during activity due to insufficient blood flow, which is not typical in venous conditions.
B) Decreased pedal pulses: In chronic venous insufficiency, pedal pulses are usually normal. Decreased pedal pulses suggest arterial disease, where blood flow is compromised. Thus, this finding would not be expected in a client with venous insufficiency.
C) Bronze/brown discoloration of the skin: This is a hallmark finding in chronic venous insufficiency. The discoloration occurs due to the deposition of hemosiderin from the breakdown of red blood cells, which is a result of prolonged venous stasis and chronic edema, particularly around the lower extremities.
D) Cool skin temperature: Skin temperature in chronic venous insufficiency is typically warm due to increased blood flow and stasis in the veins. Cool skin temperature is more characteristic of arterial insufficiency, where blood supply is reduced and can lead to cooler extremities.
E) Full screen mode is in effect during your proctored testing: This statement is irrelevant to the clinical assessment of chronic venous insufficiency and serves no purpose in understanding the client’s condition. It does not contribute to the assessment findings.