Author Question: Mr. M takes warfarin for anticoagulation following a prosthetic aortic valve replacement. He is ... (Read 147 times)

anshika · **on:** Aug 2, 2018

Mr. M takes warfarin for anticoagulation following a prosthetic aortic valve replacement. He is overall healthy, and since the surgery has begun to exercise, follow a cardiac diet, and use numerous vitamins and natural supplements.

At his clinic visit, he tells the nurse that he is taking ginkgo biloba daily. The nurse reports this to his primary care provider because: 1. Ginkgo biloba alters blood clotting and when combined with warfarin could lead to prolonged bleeding times.
2. Ginkgo biloba plays a role in synthesis of clotting factors and can increase the risk of clot formation.
3. Warfarin may decrease the effect of ginkgo biloba and decrease the international normalized ratio (INR).
4. Warfarin may increase the production of clots.

Question 2

Mr. K is a 58-year-old client at the community clinic for a routine visit. During triage, the nurse asked about any new problems and he mentioned that he has been having leg cramps that are worse at night.

A review of current medications included metoprolol and Lasix for hypertension, and terazosin for benign prostatic hypertrophy. Based on this information, the most probable cause of leg cramps would be: 1. Hypokalemia.
2. Folate deficiency.
3. Iron deficiency.
4. Vitamin D deficiency.

Leostella20 · **Reply #1 on:** Aug 2, 2018

Answer to Question 1

1
Rationale: Ginkgo biloba also alters blood clotting and when combined with warfarin could lead to prolonged bleeding times. Vitamin K plays a role in the synthesis of clotting factors and can increase the risk of clot formation. Warfarin potentiates the effect of ginkgo biloba, resulting in increased bleeding times rather than the formation of clots.

Answer to Question 2

1

Rationale: Clients taking loop diuretics, in this case lasix, are at increased risk for loss of potassium resulting in hypokalemia. Folate is lost with excessive use of alcohol. Iron is lost during chelation with certain antibiotics. Vitamins D levels can be decreased in clients using anticonvulsant medication.