一位病人被處方 warfarin。護理師應強化哪些飲食指示？（選所有適合的）
A client is prescribed warfarin. The nurse should reinforce which dietary instruction? (Select all that apply.)
- AMaintain a consistent intake of vitamin K-rich foods.✓ 正解維持富含維生素 K 食物的穩定攝取。
- BAvoid all green leafy vegetables.避免所有綠葉蔬菜。
- CLimit intake of alcohol to no more than 2 drinks per day.將酒精攝取量限制在每天不超過 2 杯。
- DIncrease intake of foods high in fiber.增加高纖維食物的攝取。
- EConsume cranberry juice daily.每日飲用蔓越莓汁。
Warfarin 飲食衛教的核心唯一重點：A. 維持「穩定」的 vitamin K 攝取量（不需避免，但不可大幅變動），這樣才能維持 INR 穩定。其他選項：B. 完全避免綠葉蔬菜不必要，重點是「穩定」而非「避免」；C. 「每日 2 杯酒」並非標準建議，多數指引建議避免或極少量飲酒（過量會干擾 warfarin 代謝並增加出血風險）；D. 高纖食物與凝血或 INR 無直接關聯，並非 warfarin 衛教的核心；E. 蔓越莓汁可能與 warfarin 交互作用提升 INR，應避免或謹慎攝取。
The single core teaching point for warfarin dietary education is A: maintain a "consistent" intake of vitamin K (it need not be avoided, but should not change significantly), so that INR remains stable. Regarding the other options: B, completely avoiding green leafy vegetables is unnecessary, since the principle is consistency rather than avoidance; C, "up to 2 drinks per day" is not a standard recommendation, and most guidelines recommend avoidance or very minimal alcohol (excessive alcohol interferes with warfarin metabolism and increases bleeding risk); D, high-fiber foods have no direct relationship with coagulation or INR and are not a core point of warfarin teaching; E, cranberry juice may interact with warfarin and increase INR, and should be avoided or consumed with caution.
美國的飲食衛教常強調「平衡」與「適量」；台灣的病人可能對特定食物（如蔓越莓）有較多疑問，需要針對性解釋。