護理師教導一位新診斷為心房顫動並服用華法林的病人。下列哪項病人陳述表示需要進一步指導有關出血預防？
A nurse is providing education to a client newly diagnosed with atrial fibrillation who is prescribed warfarin. Which statement by the client indicates a need for further teaching regarding bleeding precautions?
- AI will be careful when shaving to avoid nicks and cuts.我會小心刮鬍子以避免刮破或割傷。
- BI 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。
- CI will avoid taking aspirin or NSAIDs unless specifically ordered.除非經特別指示，否則我會避免服用阿斯匹靈或非類固醇消炎藥。
- DI will eat plenty of leafy green vegetables every day.✓ 正解我每天會攝取大量的綠葉蔬菜。
華法林（Warfarin）的抗凝血作用會受到飲食中維生素 K 攝取量的直接影響。綠葉蔬菜（如菠菜、羽衣甘藍）含有大量維生素 K，會加速凝血因子合成，從而拮抗華法林的抗凝作用，導致 INR 下降，增加血栓風險。病人應保持飲食中維生素 K 的攝取穩定，而非自行大量增加。此陳述顯示病人對藥物與飲食交互作用理解不足，需進一步教學。
The anticoagulant effect of warfarin is directly affected by dietary vitamin K intake. Leafy green vegetables (such as spinach and kale) contain large amounts of vitamin K, which accelerates the synthesis of clotting factors, antagonizes the anticoagulant effect of warfarin, lowers the INR, and increases the risk of thrombosis. Clients should maintain a stable intake of vitamin K in their diet rather than greatly increasing it on their own. This statement indicates that the client has an insufficient understanding of the drug-food interaction and requires further teaching.