The nurse is making a home visit to a patient who was discharged from the hospital on Lovenox and warfarin following replacement of the patient's pacemaker. Which observation indicates excessive bleeding? (Select all that apply.)
a. New ecchymosis on the abdomen
b. A nosebleed that does not stop with pressure
c. Pain of the lower extremity with flexion
d. Extreme fatigue
e. Pallor
f. Sudden onset of severe headache
ANS: A, B, D, E, F
Excessive bleeding includes large bruises that may be increasing in size, nosebleeds, extreme fatigue from decreased tissue oxygenation due to decreased hemoglobin, and sudden onset of a severe headache, which may indicate a cerebral hemorrhage. Pain in the lower extremity may be a result of a deep vein thrombosis. Pain of the legs with flexion may be associated with venous thrombosis.
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