You are doing discharge teaching with a patient who developed a pulmonary embolism after total knee surgery. The patient has been converted from heparin to sodium warfarin (Coumadin) anticoagulant therapy
What should the nurse tell the client?
A) Coumadin will continue to break up the clot over a period of weeks.
B) It is important to take the same brand of medicine.
C) Anticoagulant therapy usually lasts 4 to 6 weeks.
D) He should take a vitamin supplement containing vitamin K.
Ans: B
Feedback: Once the patient starts an oral regimen, it is important that he or she continue to take the same brand of warfarin, because the bioavailability may vary greatly among brands. Overanticoagulation predisposes the client to hemorrhage. Anticoagulant therapy prevents further clot formation but cannot be used to dissolve a clot. The therapy continues for approximately 6 months. Vitamin K reverses the effect of anticoagulant therapy and should not be taken in large amounts.
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The patient asks the nurse to irrigate both ear canals to improve hearing and comfort. The patient has bilateral brown ear drainage and a history of a right mastoidectomy and perforation of the left tympanic membrane
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