Question

In: Nursing

Listed below is the 48-hour recall for a 72-year-old male who is new to using warfarin....

Listed below is the 48-hour recall for a 72-year-old male who is new to using warfarin. Food or Beverage Item Serving Size Vitamin K (mcg) Day #1 Oatmeal 1 cup 1.2 Whole milk 1 cup 0.5 Orange juice ½ cup 0.1 Tuna salad ½ cup 21.2 Wheat bread 2 slices 1.1 Baby carrots 16 21.1 Roast beef 4 ounces 1.9 Baked potato w/ peel 1 medium 3.5 Butter 2 tsp 0.7 Sour cream 1 Tbsp 0.3 Tomatoes, fresh ½ cup 7.1 Applesauce 1 cup 1.5 Day #2 Special K® 1 cup 0.2 Whole milk 1 cup 0.5 Orange juice 1 cup 0.2 Roast beef 3 ounces 1.4 Wheat bread 2 slices 1.1 Salad greens 1 cup 111.5 Italian dressing 2 Tbsp 16.5 Baked chicken 4 ounces 2.7 Spinach, cooked ½ cup 554 White rice 1 cup 0 Grapes ½ cup 11.7 Q1. Looking the DRI values in the book, what is the recommendation for vitamin K intake? Is he meeting his DRI for vitamin K for Day1? What about vitamin K intake on Day 2? Is he meeting the DRI? Q2. Reading the information on vitamin K intake from the textbook and discussion in the lecture, what advice do you have for him regarding his vitamin K intake over these two days? Also look at the table closely to give specific recommendations about foods consumed. Q 3. Search the Internet for patient education materials on warfarin and vitamin K intake. Are the messages to the patient consistent? Confusing? How do you know the advice is reputable? Summarise what you found and include links for resources you explored.

Expert Solution

Age of the patient : 72 years.

1. Minimum 90 - 120 mcg of Vitamin K is recommended for patients who is on warfarin.

His day 1 Vitamin K intake is 60.2mcg.

His day 2 Vitamin K intake is 145.8mcg.

His DRI should be 90mcg per day. First day he is lack in vitamin K and next day intake is excess he is not meeting his DRI

2. By seeing his dietary recall he has to balance his vitamin K intake.

Dietary advice:

1 Oatmeal 1 cup 1.2

Whole milk 1 cup 0.5

Orange juice ½ cup 0.1

Tuna salad ½ cup 21.2

Wheat bread 2 slices 1.1

Baby carrots 16 21.1

Roast beef 4 ounces 1.9

Baked potato w/ peel 1 medium 3.5

Butter 2 tsp 0.7

Sour cream 1 Tbsp 0.3

Tomatoes, fresh ½ cup 7.1

Applesauce 1 cup 1.5 Day

Italian dressing 2tbspn 16.5

Cashews dry roasted 1 ounce 10

Salad dressing 1tbspn 15

Total Vitamin K intake for the above meal plan is 101.7 mcg.

3. Patient education:

Warfarin should be taken on schedule and must avoid taking non prescribed medications. Diet is very important for a patient who is on warfarin. There should not be a large variation in daily intake of Vitamin K. Monitor PT, INR level frequently. Avoid alcohol while taking warfarin.

Reference link:

Patient education: Warfarin (Beyond the Basics) - UpToDatehttps://www.google.com/url?sa=t&source=web&rct=j&url=https://www.uptodate.com/contents/warfarin-beyond-the-basics%23:~:text%3DPeople%2520who%2520take%2520warfarin%2520should,keep%2520the%2520INR%2520more%2520stable.&ved=2ahUKEwip-vO9qcvtAhVegtgFHWsXDpQQFjABegQIAhAE&usg=AOvVaw2cuMoeCQP9Ois0OHSe3yT1&cshid=1607876045524

https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.nursingcenter.com/journalarticle%3FArticle_ID%3D993216%26Journal_ID%3D54016%26Issue_ID%3D993051&ved=2ahUKEwip-vO9qcvtAhVegtgFHWsXDpQQFjAKegQIHxAB&usg=AOvVaw394KK0G06pf9ZzQsb33_aW&cshid=1607876045524

Nightingale answered 1 year ago

Lester is a 67-year-old male who is prescribed Warfarin for his new onset atrial fibrillation. He...

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?

Henry is a 72-year old male. After reviewing multiple 24 hour recalls from him, it was...

Henry is a 72-year old male. After reviewing multiple 24 hour recalls from him, it was determined that his average intake of major minerals was the following: Sodium: 1000 mg 1g Potassium: 3 g Phosphorus: 900 mg 0.9g Chloride: 2.3 g Calcium: 1000 mg 1g Magnesium: 390 mg 0.39g What minerals is Henry deficient in? For each mineral he is deficient in, name ONE food high in this mineral. (list the mineral and the food next to it)).

make a meal plan for a all day for a male who is 48 year old,diabete...

make a meal plan for a all day for a male who is 48 year old,diabete type 2 and weigh 290 lbs ,low active all vitamins and minerals shoul meet 90% of a RDA recommendation

Mr. Stanley London is a 72 year old retired military sergeant who has a 48 years...

Mr. Stanley London is a 72 year old retired military sergeant who has a 48 years history of smoking 20 packs of cigarettes a year. He reported having a productive cough, hoarseness, and difficulty breathing. He said all these are happening to him because he is old. He has history of several primary malignancies including, multiple melanomas, and recurrent squamous cell carcinoma of the right lower and left upper lungs. Also, he is insulin dependent Type 2 diabetes Mellitus and...

Helio is a 48-year-old sedentary male diagnosed with prediabetes who is 250 lbs and 5’7”. Helio’s...

Helio is a 48-year-old sedentary male diagnosed with prediabetes who is 250 lbs and 5’7”. Helio’s VO2max is 26 ml/kg/min. His total daily energy expenditure is 1700 kcal/d and his diet log indicates he eats ~1900 kcal/d (48% CHO, 17% protein, and 35% fat). His doctor prescribes the drug metformin to control his blood glucose and also recommends he see an exercise physiologist and nutritionist to prescribe a lifestyle program to control his weight and prevent the progression to type...

A 24-hour recall indicates that a 68-year-old healthy woman who is close to her ideal body...

A 24-hour recall indicates that a 68-year-old healthy woman who is close to her ideal body weight has eaten the following foods: Milk (skim): 0 servings Fruit: 2 servings Vegetables: 1 serving Meat: 5 servings Breads / starch: 1 serving Is this diet nutritionally adequate for her? Why or why not? Assume the 24-hour recall shown in the previous question is a typical one-day intake for this person. What, if anything, would you recommend changing in her diet?

A 64-year-old male patient diagnosed with atrial fibrillation is started on anticoagulant therapy with warfarin to...

A 64-year-old male patient diagnosed with atrial fibrillation is started on anticoagulant therapy with warfarin to lower his risk of stroke due to fibrin clots. Despite calculating initial warfarin dosing based on the patient’s age, weight, and sex, laboratory monitoring of anticoagulant activity after the first week of therapy shows that the patient is receiving too much warfarin (his INR was too high indicating he is “over anti-coagulated”). After several weeks of dose adjustment, the patient’s anticoagulant therapy is optimized...

Patient Profile HTN T.R. a 48-year old male who comes monthly to the community health screening...

Patient Profile HTN T.R. a 48-year old male who comes monthly to the community health screening for blood pressure checkups. He says he has had some headaches lately and a little dizziness. Subjective Data Is a truck driver and eats a lot of fast food States it is hard to “eat healthy” on the road Has smoked one-half pack of cigarettes per day for 30 years Objective Data Blood pressure 182/104, pulse 90, temperature 97.0° F, respirations 24 Height 5’10”,...

Mr. DeVito is a 48 old male who presents to his Primary Care Provider with left...

Mr. DeVito is a 48 old male who presents to his Primary Care Provider with left upper abdominal pain and complain of weakness and fatigue. The nurse immediately notes how pale his skin. A full set of vitals reveals the following: HR 82bpm, BP 142/90 mmhg, RR 16bpm, Spo2 94 on room air, Temp 101.0 F What further Nursing Assessment would you perform at this time? Upon further assessment, the nurse notes a palpable mass in the left upper quadrant,...

You are caring for a 72-year-old male patient admitted to a medical unit with an exacerbation...

You are caring for a 72-year-old male patient admitted to a medical unit with an exacerbation of chronic obstructive pulmonary disease. He is anemic, and you are transfusing him with 2 units of PRBCs. The second unit is almost completed when he complains of more shortness of breath and appears anxious. His pulse is 118 bpm, respirations 28 per minute, BP 104/60, and temperature 37.2° C (99° F). What might be the etiology of his respiratory distress? How will you...