Diet that is indicated for a patient receiving anticoagulation of warfarin therapy is?

Appeared in: PGIMER NO - 2020

Explanation

Warfarin is an anticoagulant that works by inhibiting the synthesis of Vitamin K-dependent clotting factors (II, VII, IX, and X).
A diet high in Vitamin K directly counteracts the therapeutic effect of warfarin, reducing its ability to prevent blood clots.
Therefore, patients are advised to maintain a consistent and generally low intake of Vitamin K to keep their International Normalized Ratio (INR) within the target therapeutic range.

Option A: Potassium levels are not directly related to warfarin's mechanism of action.
Option B: This is strongly contraindicated. A high Vitamin K intake will reverse the anticoagulant effects of warfarin, increasing the risk of thrombosis.
Option C: This describes a general diet and has no specific therapeutic or contraindicated relationship with warfarin therapy.

Clinical Relevance

Nursing practice connection: Use the key finding related to Dietary management for warfarin therapy to guide bedside assessment, documentation, and the next nursing action.
Patient education is a critical nursing responsibility. The nurse must teach the patient on warfarin to maintain a consistent dietary intake of Vitamin K, not to eliminate it completely, to ensure a stable INR.
Nurses must monitor the patient's INR closely (target range is typically 2.0-3.0) and assess for signs of bleeding (e.g., unusual bruising, hematuria, black stools) or clotting (e.g., sudden leg pain, chest pain, shortness of breath).
What if? If a patient's INR drops below the therapeutic range (e.g., to 1.5), the nurse's first action should be to assess the patient's recent dietary intake for any sudden increases in Vitamin K-rich foods, as this is a common cause for a subtherapeutic level.

How to Approach the Question

First, identify the key medication in the question: warfarin.
Second, recall the mechanism of action of warfarin. It is a Vitamin K antagonist, meaning it works against Vitamin K.
Third, deduce the relationship between the drug and diet. Since warfarin's action is opposed by Vitamin K, a diet high in Vitamin K would make the drug less effective.
Fourth, evaluate the options based on this interaction. A diet low or consistent in Vitamin K is the logical choice to allow the drug to work properly. The other options (potassium, carbs/protein) are not directly related to warfarin's primary mechanism.

Concept Tested & Keywords

Q1Jh48cj7eDfx2Qwxjcz-c

E6 Pharmacology Nursing Lilley 11e Part 2 p. 112-114

E6 Pharmacology Nursing Lilley 11e Part 3 p. 201-203

Practise the full PGIMER NO - 2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.