Author Question: A patient inadvertently took an excessive dose of warfarin (Coumadin) and was immediately treated ... (Read 44 times)

elizabeth18 · **on:** Jul 23, 2018

A patient inadvertently took an excessive dose of warfarin (Coumadin) and was immediately treated with IV vitamin K (Phytonadione). The symptoms that would most concern the nurse after administration of vitamin K are

a. mild pruritus, pulse of 92.
b. respirations of 32, bronchoconstriction, O2 sats of 83.
c. prolonged sensitization to warfarin (Coumadin).
d. blood pressure of 107/52 and bleeding gums.

Question 2

People with alcoholism and those who take isoniazid should be monitored for which vitamin B6related complications? (Select all that apply.)

a. Sprue
b. Glossitis
c. Microcytic anemia
d. Seborrheic dermatitis
e. Changes in neurologic function

Mholman93 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

B
The patient is experiencing a hypersensitivity reaction to the phytonadione, which is manifested by impending respiratory distress associated with IV administration of the drug.
Mild pruritus may be significant, but the pulse is within normal limits. The greatest concerns are the low O2 sats and bronchoconstriction .
There is no indication of how long the patient was exposed to warfarin, therefore sensitization is not a correct choice.
A blood pressure of 107/52 is not significant, because it may be baseline for the patient. Bleeding gums are an anticipated effect of excessive warfarin and would not be a significant finding after administration of the vitamin K.

Answer to Question 2

C, D, E
Vitamin B6 deficiency likely is related to alcoholism or the use of isoniazid, which prevents conversion of the vitamin to its active form and may induce symptoms of deficiency, such as se-borrheic dermatitis, microcytic anemia, peripheral neuritis, convulsions, depression, and confu-sion.
Vitamin B6 deficiency does not induce sprue or glossitis.