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 C
Explanation
A) Increase of high-density lipoproteins: While higher levels of high-density lipoproteins (HDL) are generally associated with a lower risk of cardiovascular disease, enalapril is not primarily used to target lipid levels. Its main purpose is to manage blood pressure and reduce the risk of heart failure and renal complications, rather than specifically affecting HDL levels.
B) Decreased pain from intermittent claudication: Intermittent claudication is typically related to peripheral artery disease, which may not be directly improved by enalapril. While managing blood pressure can indirectly benefit circulation, enalapril is not indicated specifically for alleviating pain associated with claudication.
C) Decreased blood pressure: Enalapril is an ACE inhibitor used primarily to treat hypertension. A significant decrease in blood pressure is a direct therapeutic effect of the medication, indicating that it is effectively managing the client’s condition. Monitoring blood pressure helps assess the medication's efficacy in achieving the desired therapeutic outcome.
D) Decrease in low-density lipoproteins: Although reducing low-density lipoprotein (LDL) levels can benefit cardiovascular health, enalapril is not primarily prescribed for this purpose. Its effects on lipid levels are minimal compared to its role in lowering blood pressure and protecting renal function, making a decrease in LDL levels an irrelevant indicator of its therapeutic effect.
Correct Answer is ["B","E"]
Explanation
A) Provide discharge instructions for a client who has a new skin graft: This task should not be delegated to an assistive personnel (AP) as it requires clinical judgment and knowledge about the specific care needs associated with a new skin graft. Discharge instructions must be provided by a qualified nurse.
B) Weigh a client who is on fluid restriction: This task can be delegated to an AP. Weighing a client is a straightforward procedure that does not require nursing judgment and is within the scope of practice for an AP.
C) Check a blood product with another nurse prior to administration: This task must be performed by a licensed nurse to ensure patient safety and compliance with protocols. Checking blood products requires knowledge of the client's specific needs and potential reactions.
D) Perform an admission assessment on a client: Admission assessments require nursing expertise and critical thinking. This task cannot be delegated to an AP, as it involves evaluating the client's condition and creating a care plan based on the assessment findings.
E) Ambulate an older adult client who has hypertension: This task can be delegated to an AP, provided the client is stable and there are no other complications. Assisting with ambulation is within the scope of practice for an AP, and it can help promote mobility and independence for the client.