A patient who is taking an oral anticoagulant is in the clinic in the late afternoon and reports having missed the morning dose of the medication because the prescription was not refilled. The primary care NP should counsel this patient to:
a. avoid foods that are high in vitamin K for several days.
b. take a double dose of the medication the next morning.
c. refill the prescription and take today's dose immediately.
d. skip today's dose and resume a regular dosing schedule in the morning.
D
Consistency is the key to successful warfarin treatment, and the patient should take the medication at the same time every day. For missed doses, the patient should take the medication as soon as possible after the missed dose or not at all that day. Because it is late afternoon, the patient should skip the dose and resume normal scheduling the next day. It is not necessary to avoid foods high in vitamin K. Patients should not double up the next day.
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