護理師對開始服用 warfarin 的病人進行衛教。下列哪些說明顯示病人仍需進一步指導？（選所有適合的）
A nurse is educating a client starting warfarin therapy. Which statements by the client indicate a need for further instruction? (Select all that apply.)
- AI will increase my intake of green leafy vegetables✓ 正解我會增加深綠色蔬菜的攝取量
- BI will use a soft-bristled toothbrush for oral hygiene我會使用軟毛牙刷進行口腔清潔
- CI will take an extra dose if I miss my medication by 2 hours✓ 正解如果錯過用藥時間達 2 小時，我會額外服用一劑
- DI will notify my dentist about taking this medication我會告知牙醫我正在服用此藥物
- EI will consult my provider before taking over-the-counter herbal supplements在服用非處方草藥補充劑前，我會諮詢我的醫師
Warfarin 作用為維生素 K 拮抗劑。攝取過多綠色蔬菜（含大量維生素 K）會抵銷藥效（A 錯誤）；漏藥時絕對不可自行補服雙倍劑量，應遵從醫師建議（C 錯誤）。使用軟毛牙刷（B）可防牙齦出血、告知牙醫（D）為預防手術出血、諮詢草藥（E）為預防藥物交互作用，皆為正確觀念。
Warfarin acts as a vitamin K antagonist. Consuming large amounts of green leafy vegetables (rich in vitamin K) counteracts the drug's effect (A is incorrect). The client must never take a double dose to make up for a missed dose; the prescriber's directions should be followed instead (C is incorrect). Using a soft-bristled toothbrush (B) prevents gum bleeding, notifying the dentist (D) prevents bleeding complications during procedures, and consulting the provider about herbal supplements (E) helps prevent drug interactions; these are all correct concepts.
美國有針對 warfarin 的抗凝血門診（Anticoagulation Clinic）由藥師或專科護理師管理；台灣目前多由心臟內科醫師開立並衛教。