護理師教導病人有關華法林（Warfarin）的藥物指導。哪項敘述顯示病人需要進一步教育？
A nurse is teaching a client about warfarin therapy. Which statement by the client indicates a need for further teaching?
- AI will take an extra dose if I miss my scheduled time✓ 正解如果我錯過預定服藥時間，我會額外服用一劑
- BI will eat a consistent amount of green leafy vegetables我會保持攝取綠色葉菜類的量一致
- CI will report any unusual bruising or bleeding to my doctor我會向醫師報告任何異常的瘀青或出血
- DI will use a soft-bristled toothbrush for oral hygiene我會使用軟毛牙刷進行口腔清潔
華法林（Warfarin）是一種維生素 K 拮抗劑，透過抑制肝臟合成凝血因子來達到抗凝血效果。其治療窗（Therapeutic window）窄，劑量調整需嚴格依據國際標準化比值（INR）監測。病人自行服用額外劑量會導致 INR 過高，引發致命性大出血。護理師需確認病人理解藥物依從性及出血風險監測，擅自補藥是嚴重的用藥錯誤。
Warfarin is a vitamin K antagonist that produces its anticoagulant effect by inhibiting hepatic synthesis of clotting factors. It has a narrow therapeutic window, and dose adjustments must be guided strictly by the INR. Taking an extra dose on the client's own initiative can elevate the INR excessively, leading to life-threatening hemorrhage. The nurse must confirm that the client understands medication adherence and monitoring for bleeding; self-administering an additional dose is a serious medication error.
美國醫療體系非常強調病人對 INR 監測的認知，護理師通常會教導病人使用特定的手機 App 或紀錄表來追蹤 INR 值，並確保他們了解「漏藥」與「補藥」的具體臨床指引。