Anabelle is a 70-year old female with a history of atrial fibrillation. This condition puts her...

Anabelle is a 70-year old female with a history of atrial fibrillation. This condition puts her at risk for an embolic stroke. Her physician prescribed her the “blood thinner” coumadin. Her physician advised her to limit her intake of kale, spinach and similar vegetables. Why was she given this advice? What test must she have routinely done to assure therapeutic levels of this medication. What is the mechanism of action for coumadin?

Expert Solution

Kale, spinach and similar vegetable are rich in vitamin K, these vitamin K works against drugs like coumadin which mainly contains Warfarin. Vitamin K aids clotting, so patients on the anti-clotting drug like warfarin are often warned by their physicians to limit the amount of foods rich in the nutrient.The blood test, called prothrombin time, is used to calculate your International Normalized Ratio (INR). Your INR helps your healthcare provider determine how well warfarin is working to prevent blood clots and if the dose needs to be adjusted.

Liver produces certain co factors which are responsible for clotting, Vitamin K controls the creation of these cofactors in your liver, a drug like coumadin work by competitively inhibits the vitamin K epoxide reductase complex (VKORC1), which is an essential enzyme responsible for activating the vitamin K available in the body, this can deplete functional vitamin K reserves and therefore reduce the synthesis of active clotting factors. By blocking the process early on, coumadin ultimately help to reduce blood clots from forming in your body.

Sydney Mullin answered 1 year ago

A 65-year-old man with a history of atrial fibrillation presents to his PCP’s office 2 months...

A 65-year-old man with a history of atrial fibrillation presents to his PCP’s office 2 months after suffering from a myocardial infarction.  He declined anticoagulation due to fear he would bleed to death. He has had sudden-onset, moderately severe diffuse abdominal pain that began 18 hours ago. He has been vomiting, and he has had several episodes of diarrhea, the last of which was bloody. He has a fever of 100.9 ˚ F. CBC reveals WBC of 15,000/mm3. What is...

Mrs. C., an independent, 96-year-old woman, has a history of rehospitalization because of atrial fibrillation resulting...

Mrs. C., an independent, 96-year-old woman, has a history of rehospitalization because of atrial fibrillation resulting from CHF and hypertension. After her most recent hospitalization, Mrs. C. was treated and released into home care at an agency in Washington. A home telemonitoring system that tracks and transmits patients’ vital signs was placed in her home. The primary goal of placing this patient on the telemonitor was to provide daily monitoring of her condition, thereby avoiding unnecessary rehospitalizations. One morning, Mrs....

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...

Your patient is an active 80-year-old woman with heart failure and chronic atrial fibrillation. You are...

Your patient is an active 80-year-old woman with heart failure and chronic atrial fibrillation. You are taking an angiotensin-converting enzyme inhibitor, a beta-blocker, a diuretic, and digoxin. During her evaluation, she tells him that she felt very dizzy this morning. How would you approach your evaluation and why? Identify some of the key evaluation factors. What nursing interventions are necessary? How would you change your evaluation and interventions if your patient also had chronic obstructive pulmonary disease and kidney failure?

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?

A 22 year old female with no previously known medical history presented to her primary care...

A 22 year old female with no previously known medical history presented to her primary care doctor for a 2 month history of intermittently increased spasticity of her upper extremities and intermittent paralysis of her lower extremities with no known cause. She states that her symptoms seem to “come and go” without a known cause, usually worse in the mornings. Her biomedical engineering college professors have not been very accommodating to her symptoms, however, and have instructed her to be...

History of present illness: This 72-year-old female presented to the ENT clinic complaining of her current...

History of present illness: This 72-year-old female presented to the ENT clinic complaining of her current epistaxis for 7 days prior to admission. The bleeding usually occurred from the right nostril. She had no prior history of epistaxis and denied any rhinorrhea. congestion, or anemia. On admission, she also complained of weakness. Four days prior to admission, her hematocrit level was 35, and the night before her admission, her hematocrit level was 29 when measured at an outside hospital. Her...

Assessment: Chief Complaint: 72-year-old woman who fell on her right hip. History: 72-year-old white female, was...

Assessment: Chief Complaint: 72-year-old woman who fell on her right hip. History: 72-year-old white female, was brought to the Emergency Room after falling. She was previously in good health, despite leading a relatively sedentary lifestyle and having a 30-year history of cigarette smoking. The only medication she currently takes is propranolol for mild hypertension. She fell upon entering the bathtub when her right leg slipped out from under her; she landed on her right hip. There was no trauma to...

History: Margaret Donovan, a 72-year-old white female, was brought to the emergency room by her son-in-law...

History: Margaret Donovan, a 72-year-old white female, was brought to the emergency room by her son-in-law after falling in her bathtub. She was previously in good health, despite leading a relatively sedentary lifestyle and having a 30-pack-year history of cigarette smoking. The only medication she currently takes is Inderal (propranolol) for mild hypertension. She fell upon entering the bathtub when her right leg slipped out from under her; she landed on her right hip. There was no trauma to her...

a. Mrs. Ho is a 55 year old female with a five year history of type...

a. Mrs. Ho is a 55 year old female with a five year history of type 2 diabetes and hypertension. She has been brought into the ER via an ambulance. While at home watching TV on her sofa, she developed crushing sub-sternal chest pain (9/10) which radiates to her back and left arm. She took a S.L. nitroglycerin and five minutes later took another when the pain did not subside. She called 911. She is very frightened because her chest...

Question