Editing Nutrition – RN Practice Questions (section)

==Question 7==
A client newly prescribed warfarin asks about diet. Which instruction should the nurse provide?
# "Completely eliminate green leafy vegetables from your diet."
# "Eat a large green salad every day to keep your blood thin."
# "Keep your intake of green leafy vegetables about the same from week to week."
# "Take a daily multivitamin containing vitamin K to keep your levels steady."

'''Answer:''' 3. "Keep your intake of green leafy vegetables about the same from week to week."

''Rationale:'' Warfarin works by antagonizing vitamin K-dependent synthesis of clotting factors II, VII, IX, and X. The dose is titrated to the client's habitual vitamin K intake, so consistency is the goal. A sudden surge in vitamin K lowers the INR and increases clot risk, while abrupt elimination raises the INR and increases bleeding risk. Options 1 and 2 both create swings and remove nutritionally valuable foods. Option 4 adds a vitamin K source that will require dose readjustment and should not be started without provider direction.