A nurse is caring for a patient who is exhibiting signs of an adverse reaction to warfarin (Coumadin). Which statements made by the patient would lead the nurse to suspect that this is the case?

Question

1. "I'm from the South, and we have buttermilk almost every meal."
2. "I was suffering so much from hot flashes until my friend told me to try an herb called St. John's wort. I don't seem to have as many symptoms as before."
3. "My husband makes me put garlic in everything! He heard it helps keep our blood pressure normal."
4. "I heard ginkgo was really good for improving memory so I started taking it a couple of months ago."
5. "I was having difficulty sleeping a couple months ago, and my neighbor recommended I try kava. It seems to calm my nerves."

Answer 1

Correct Answer: 1,2,3,4
Rationale 1: Calcium products do not affect the action of warfarin.
Rationale 2: St. John's wort may increase the risk for bleeding when taken with warfarin.
Rationale 3: Garlic may increase the risk for bleeding when taken with warfarin.
Rationale 4: Ginkgo may increase the risk for bleeding when taken with warfarin.
Rationale 5: Kava can increase drowsiness and sedation when taken with CNS depressants. It does not interact with warfarin.