As the nurse, you are developing a discharge plan for a client who has had valve replacement surgery and is on warfarin. You know the client understands the plan when she states:
1. "I need to report bruising, bleeding, epistaxis, and hemoptysis to my health care provider.".
2. "I need to eat large amounts of yellow and dark green vegetables.".
3. "I should take aspirin and anti-inflammatory drugs (NSAIDs) for pain.".
4. "I should avoid red meat.".
"I need to report bruising, bleeding, epistaxis, and hemoptysis to my health care provider.".
Rationale: Bruising, bleeding, epistaxis, and hemoptysis are all signs of abnormal bleeding, which may indicate that a change is needed to the warfarin dosage. Yellow and green vegetables should be avoided due to the vitamin K content, which counteracts the warfarin. Aspirin and NSAIDs also cause bleeding and would be contraindicated while taking warfarin. Red meat has no significance for this client.
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