Question

Lester is a 67-year-old male who is prescribed Warfarin for his new onset atrial fibrillation. He is concerned about starting this medication and admits he is forgetful about taking meds and doesn’t understand why he has to have follow-up blood tests. Discuss the patient education you would offer about Warfarin (include side effects). How would you address his concerns and questions? How can you ensure your patient education information is accurate and up to date?

Answer 1

1.Patient Education on Warfarin:

Warfarinis an oral anticoagulant that blocks Vitamin K dependent coagulation factors and thereby, takes time for clot formation and prevents the risk of complications such as stroke, heart attacks, deep vein thrombosis and pulmonary embolism.

Warfarin is given to patients with Atrial fibrillation in order to prevent stroke which is a long term complication of atrial fibrillation.

The common side effects of warfarin are bleeding from gums, nose, stool, urine, vomitus, gastrointestinal tract and intracerebral hemorrhage.Intracerebral bleeding could manifest as headache and confusion due to increased intracranial pressure.

Always use soft tooth brush to prevent gum bleeding

Floss reguarly

Use electric razor rather shaving

Be cautious while handling sharp objects to avoid injury that may bleed

Avoid activities that may cause falls or accidents

Carry medication alert tags while travelling

Avoid eating too many foods rich in Vitamin K such as green leafy vegetables because it may interfere with action of warfarin

Avoid alcohol or limit to 1 or 2 servings a day due to it's anticoagulant effects

2.Patient is forgetting about taking medicine

Have a medicine card with date and time mentioned

Have a daily diary of medicine taken

If not taken medication at correct time, immediately contact physician

Never change dozing of warfarin as it may increase the chance of bleeding or may result in clots.

3.Reason to undergo blood tests

Blood clotting time is measured by prothrombin time(PT).International method to represent prothrombin time is INR which means international normalized ratio.If INR is too low, blood clot formation cannot be prevented and if INR is too high, then there is high risk for bleeding.Warfarin dozing depends on PT INR values.So it is mandatory to take blood tests at least weekly once and in every month.

4.If patient education information is up to date?

The patient education information is based on the guidelines formulated by American Heart Association.This is an international body that regulates treatment guidelines on Heart Conditions.So the information is ensured to be up to date.