A nurse is caring for a client who is exhibiting signs of an ...

[ghost!]

A nurse is caring for a client who is exhibiting signs of an adverse reaction to warfarin (Coumadin). Which statements made by the client would lead the nurse to suspect that this is the case?
 
  1. I'm from the South, and we have buttermilk almost every meal.
  2. I was suffering so much from hot flashes until my friend told me to try an herb called St. John's wort. I don't seem to have as many symptoms as before.
  3. My husband makes me put garlic in everything He heard it helps keep our blood pressure normal.
  4. I heard ginkgo was really good for improving memory so I started taking it a couple of months ago.
  5. I was having difficulty sleeping a couple months ago, and my neighbor recommended I try kava. It seems to calm my nerves.

Question 2

A client returns to the clinic for follow up after taking a newly prescribed medication for a month. The nurse recognizes medication teaching was successful when the client makes which statement?
 
  1. I've been taking my medication on an empty stomach, like the prescription label said to do.
  2. I always take my medication with a full glass of water.
  3. I'm not drinking any alcohol close to the time that I take my medication.
  4. I switched all my medications to one pharmacy, like you suggested.
  5. I was glad I could take my medications and supplements together. I don't really like to take a lot of pills during the day.

[meryzewe]

Answer to Question 1

Correct Answer: 2,3,4
Rationale 1: Calcium products do not affect the action of warfarin.
Rationale 2: St. Johns's wort may increase the risk for bleeding when taken with warfarin.
Rationale 3: Garlic may increase the risk for bleeding when taken with warfarin.
Rationale 4: Ginkgo may increase the risk for bleeding when taken with warfarin.
Rationale 5: Kava can increase drowsiness and sedation when taken with CNS depressants. It does not interact with warfarin.
Global Rationale: St. Johns's wort may increase the risk for bleeding when taken with warfarin. Garlic may increase the risk for bleeding when taken with warfarin. Ginkgo may increase the risk for bleeding when taken with warfarin. Calcium products do not affect the action of warfarin. Kava can increase drowsiness and sedation when taken with CNS depressants. It does not interact with warfarin.

Answer to Question 2

Correct Answer: 1,2,3,4
Rationale 1: Some medications must be taken on an empty stomach. It is important to know if the medication should be taken with food or on an empty stomach.
Rationale 2: Taking medications with water will decrease the chance of an interaction that can occur with other juices or fluids.
Rationale 3: Alcohol can cause adverse interactions with medications.
Rationale 4: Filling all prescriptions at the same pharmacy will assist the pharmacist in comparing current and new medications for interactions.
Rationale 5: It is best not to take herbal supplements and vitamins with prescribed medications to avoid interactions.
Global Rationale: Some medications must be taken on an empty stomach. It is important to know if the medication should be taken with food or on an empty stomach. Taking medications with water will decrease the chance of an interaction that can occur with other juices or fluids. Alcohol can cause adverse interactions with medications. Filling all prescriptions at the same pharmacy will assist the pharmacist in comparing current and new medications for interactions. It is best not to take herbal supplements and vitamins with prescribed medications to avoid interactions.

[ghost!]

Both answers were spot on, thank you once again

[meryzewe]

Great! Please up vote