— 藥理與非經腸給藥 · MEDIUM · SATA —
關於華法林(Warfarin)的給藥護理，下列哪些措施是適當的？（選所有適合的）
Which of the following interventions are appropriate when administering Warfarin? (Select all that apply.)
- AMonitor the International Normalized Ratio (INR)✓ 正解監測國際標準化比值（INR）
- BAdvise the client to eat consistent amounts of leafy green vegetables✓ 正解建議病人攝取固定量的深綠色蔬菜
- CInstruct the client to use a soft-bristled toothbrush✓ 正解指示病人使用軟毛牙刷
- DAdminister Vitamin K as an antidote if INR is therapeutic若 INR 在治疗範圍內，給予維生素 K 作為解毒劑
- ECheck for signs of bleeding such as hematuria or melena✓ 正解檢查是否有血尿或黑便等出血跡象
— Explanation · 中文詳解 —
華法林治療需依賴 INR 調整劑量。維生素 K 會拮抗華法林作用，飲食必須保持穩定攝取量以維持藥效穩定。病人需防範出血風險，包含使用軟毛牙刷及觀察內出血徵兆。維生素 K 為嚴重出血時的解毒劑，非治療期間常規給予。
Warfarin therapy requires dose adjustment based on the INR. Vitamin K antagonizes the effect of warfarin, so dietary intake must remain consistent in order to maintain stable drug effect. The client must take precautions against bleeding, including using a soft-bristle toothbrush and watching for signs of internal bleeding. Vitamin K is the antidote for serious bleeding and is not given routinely during therapy.
✦ 台美臨床差異
台灣目前針對房顫病人，臨床上已有許多病人改用 NOAC（新一代口服抗凝血劑），但華法林仍需監測 INR。