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) Apply cold therapy to the affected leg: Cold therapy may be used for certain conditions to reduce swelling and pain, but in the case of suspected deep vein thrombosis (DVT) indicated by redness, warmth, tenderness, and pain in the calf, cold therapy is not appropriate. Instead, the focus should be on confirming the diagnosis before applying any treatment.
B) Monitor Homan's sign: Homan's sign involves dorsiflexion of the foot to assess for pain in the calf, which can suggest DVT. However, it is no longer considered a reliable diagnostic tool. Instead, confirmation through imaging or other diagnostic measures is preferred, so simply monitoring this sign would not be sufficient in this situation.
C) Obtain a venous duplex ultrasound: A venous duplex ultrasound is the gold standard for
diagnosing DVT. Given the client’s symptoms—redness, warmth, tenderness, and pain in the calf—the appropriate order is to obtain this ultrasound to confirm the presence of a thrombus. This imaging study provides critical information for diagnosis and subsequent management.
D) Obtain impedance plethysmography: While impedance plethysmography can assess venous flow and help diagnose DVT, it is less commonly used than venous duplex ultrasound. The more direct and widely accepted method for diagnosing DVT in this scenario is the ultrasound, making this option less suitable as the initial order.
Correct Answer is ["A","D","F"]
Explanation
A) Smoking cessation: Quitting smoking is one of the most critical interventions for clients with peripheral arterial disease (PAD). Smoking contributes to vascular damage and worsens arterial circulation, so cessation can significantly slow disease progression and improve overall cardiovascular health.
B) Wear compression stockings: While compression stockings may be helpful for venous conditions, they are generally not recommended for clients with PAD. In fact, they can impair arterial flow, so this intervention should not be included in the teaching plan.
C) Use a heating pad directly on the legs: Using a heating pad directly on the legs is unsafe for clients with PAD, as it can lead to burns or injuries due to impaired sensation in the extremities. Additionally, excessive heat can exacerbate circulation issues.
D) Exercising will help increase circulation: Regular exercise is beneficial for clients with PAD. Supervised exercise programs, such as walking, can improve circulation and enhance functional capacity, helping to manage symptoms and slow disease progression.
E) Soak feet in hot water daily: Soaking feet in hot water can pose risks, particularly for individuals with PAD, as they may have reduced sensation and are at higher risk for burns or injuries. This practice should not be recommended.
F) Decrease saturated fats in daily diet: Reducing saturated fats in the diet can help improve overall cardiovascular health and lower cholesterol levels, which is beneficial for clients with PAD. A heart-healthy diet can help limit disease progression and improve circulation.