A client presents to the emergency department with influenza-like symptoms. The nurse assesses the client's medication history and finds that the client has been taking ibuprofen for arthritic pain

Question

Warfarin (Coumadin) was recently prescribed due to a diagnosis of atrial fibrillation. What is the nurse's rationale for immediately discussing this finding with the health care provider?
1. If taken with NSAID medications, warfarin can cause a change in the client's oral mucosa and white patchy lesions.
2. Oral anticoagulants taken with ibuprofen can increase the risk of bleeding.
3. Taking ibuprofen and warfarin at the same time decreases the client's immune response.
4. Ibuprofen is contraindicated for patients who have influenza-like symptoms.

Answer 1

Correct Answer: 2
Rationale 1: Warfarin does not cause oral lesions.
Rationale 2: Ibuprofen inhibits platelet aggregation and prolongs the bleeding time without affecting the prothrombin or whole blood–clotting times. Oral anticoagulants taken with ibuprofen can increase the risk of bleeding.
Rationale 3: Concurrent use of warfarin and ibuprofen does not affect immune response.
Rationale 4: There is no reason ibuprofen should not be taken by clients with influenza-like symptoms.
Global Rationale: Ibuprofen inhibits platelet aggregation and prolongs the bleeding time without affecting the prothrombin or whole blood–clotting times. Oral anticoagulants taken with ibuprofen can increase the risk of bleeding. Ibuprofen's effects on platelets are reversible within 24 hours after discontinuation of the drug. Warfarin does not cause oral lesions or affect the immune response. There is no reason ibuprofen should not be taken by clients with influenza-like symptoms.