Author Question: The nurse is assessing a patient who takes warfarin (Coumadin). The nurse notes a heart rate of 92 ... (Read 83 times)

TFauchery · **on:** Jul 23, 2018

The nurse is assessing a patient who takes warfarin (Coumadin). The nurse notes a heart rate of 92 beats per minute and a blood pressure of 88/78 mm Hg. To evaluate the reason for these vital signs, the nurse will assess the patient's

a. gums, nose, and skin.
b. lung sounds and respiratory effort.
c. skin turgor and oral mucous membranes.
d. urine output and level of consciousness.

Question 2

The nurse is teaching a patient who will begin taking warfarin (Coumadin) for atrial fibrillation. Which statement by the patient indicates understanding of the teaching?

a. I should eat plenty of green, leafy vegetables while taking this drug.
b. I should take a nonsteroidal anti-inflammatory drug (NSAID) instead of acetaminophen for pain or fever.
c. I will take cimetidine (Tagamet) to prevent gastric irritation and bleeding.
d. I will tell my dentist that I am taking this medication.

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

Answer to Question 1

ANS: A
An increased heart rate followed by a decreased systolic pressure can indicate a fluid volume deficit caused by internal or external bleeding. The nurse should examine the patient's mouth, nose, and skin for bleeding. These vital signs do not indicate a pulmonary problem. Skin turgor and mucous membranes as well as urine output and level of consciousness may be assessed to determine the level of fluid deficit, but finding the source of blood loss is more important. Signs of gastrointestinal bleeding should also be assessed.

Answer to Question 2

ANS: D
Patients taking warfarin should tell their dentists that they are taking the medication because of the increased risk for bleeding. Patients should avoid foods high in vitamin K, which can decrease the effects of warfarin. Patients should not take NSAIDs or cimetidine (Tagamet) because they can displace warfarin from protein-binding sites.