Author Question: A patient who is taking an oral anticoagulant is in the clinic in the late afternoon and reports ... (Read 25 times)

Yi-Chen · **on:** Jul 24, 2018

A patient who is taking an oral anticoagulant is in the clinic in the late afternoon and reports having missed the morning dose of the medication because the prescription was not refilled. The primary care NP should counsel this patient to:

a. avoid foods that are high in vitamin K for several days.
b. take a double dose of the medication the next morning.
c. refill the prescription and take today's dose immediately.
d. skip today's dose and resume a regular dosing schedule in the morning.

Question 2

A patient tells the primary care NP that he has difficulty getting and maintaining an erection. The NP's initial response should be to:

a. prescribe sildenafil (Viagra).
b. perform a medication history.
c. evaluate his cardiovascular status.
d. order a papaverine injection test to screen for erectile dysfunction.

ilianabrrr · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

D
Consistency is the key to successful warfarin treatment, and the patient should take the medication at the same time every day. For missed doses, the patient should take the medication as soon as possible after the missed dose or not at all that day. Because it is late afternoon, the patient should skip the dose and resume normal scheduling the next day. It is not necessary to avoid foods high in vitamin K. Patients should not double up the next day.

Answer to Question 2

B
Because the use of multiple medications is associated with a higher prevalence of erectile dysfunction, a medication history should be performed first to see if any medications have sexual side effects. A cardiovascular evaluation may be assessed next. Papaverine injection tests are useful screening tools after a thorough history has been performed. Medications are prescribed only after a diagnosis is determined and other causes have been ruled out.