A client is maintained on warfarin (Coumadin) therapy secondary to refractory atrial fibrillation. Which statement by the client would alert the nurse to a possible problem with this therapy?
1. "I have started taking a vitamin C supplement to prevent colds this winter."
2. "I am learning to use olive oil in my cooking."
3. "I've stopped drinking coffee and now drink decaffeinated green tea."
4. "I have a big glass of grapefruit juice with my breakfast every day."
Correct Answer: 3
Rationale 1: There is no adverse drug–drug interaction between warfarin and vitamin C.
Rationale 2: There is no adverse food–drug interaction between warfarin and olive oil.
Rationale 3: Drinking green tea while taking warfarin may increase the risk of bleeding.
Rationale 4: There is no adverse food–drug interaction between grapefruit juice and warfarin.
Global Rationale: Drinking green tea while taking warfarin may increase the risk of bleeding. There is no adverse drug–drug interaction between warfarin and vitamin C, olive oil, or grapefruit juice.
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