The nurse is teaching the client regarding use of sodium warfarin. Which statement made by the client would require further teaching?

Appeared in: DHS 2018 shift 1st

Explanation

The statement about taking aspirin for a headache indicates a dangerous misunderstanding requiring immediate nursing intervention.
Warfarin is an anticoagulant that works by inhibiting vitamin K-dependent clotting factors.
Aspirin is an antiplatelet drug that also increases bleeding risk.
Combining an anticoagulant (warfarin) with an antiplatelet drug (aspirin) synergistically increases the risk of major bleeding and hemorrhage.
Patient teaching must emphasize avoiding aspirin and NSAIDs and using safer alternatives like acetaminophen for pain relief.

Option A: This statement is correct and shows proper understanding. Warfarin has a narrow therapeutic window, and regular blood tests (PT/INR) are essential to monitor its effectiveness and prevent complications.
Option B: This statement is correct and shows the patient is aware of potential side effects. Warfarin-induced skin necrosis is a rare but serious adverse reaction, so monitoring for rashes is an important self-care action.
Option D: This statement is correct and demonstrates understanding of bleeding precautions. Using an electric razor instead of a blade razor reduces the risk of nicks and cuts, which can lead to prolonged bleeding in a patient on anticoagulants.

Clinical Relevance

Nursing practice connection: Knowing Patient education for anticoagulant therapy (Warfarin) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Patient education is a critical nursing responsibility to prevent adverse drug events. For high-risk medications like warfarin, clear and repeated instruction is key to patient safety.
Failure to correct a patient's misunderstanding about concomitant aspirin use can lead to life-threatening gastrointestinal bleeding or intracranial hemorrhage.
What if? If the patient reported taking a prescribed low-dose aspirin for cardiovascular protection, the nurse's priority would be to verify the orders with the prescribing physician to ensure the combined therapy is intentional and to discuss the heightened bleeding risk and monitoring plan.

How to Approach the Question

First, identify the core subject of the question: patient teaching for warfarin.
Next, recall the drug class and primary mechanism/risk of warfarin. It is an anticoagulant, and its main risk is bleeding.
The question asks which statement requires 'further teaching,' which means you are looking for an incorrect or dangerous action by the patient.
Evaluate each option against the standard safety precautions for anticoagulants.
Option A (blood draws) is standard monitoring. Option B (skin check) is a valid precaution for a known side effect. Option D (electric razor) is a standard bleeding precaution.
Option C (taking aspirin) involves combining two drugs that both increase bleeding risk, which is a well-known and dangerous interaction. This statement clearly indicates a knowledge deficit.

Concept Tested & Keywords

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E6 Pharmacology Nursing Lilley 11e Part 2 p. 127-129

Practise the full DHS 2018 shift 1st

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