護理師準備為有深部靜脈栓塞病史的病人給予華法林（Warfarin）。下列何種發現應回報醫療團隊？（選所有適合的）
A nurse is preparing to administer warfarin to a client with a history of deep vein thrombosis. Which findings should the nurse report to the healthcare provider? (Select all that apply.)
- AThe current INR is 4.5✓ 正解目前的 INR 為 4.5
- BThe client consumes a large salad daily病人每天食用大量沙拉
- CThe client reports dark, tarry stools✓ 正解病人報告排出黑色焦油樣糞便
- DThe client has a nosebleed that is difficult to stop✓ 正解病人有難以止住的鼻出血
- EThe client is also taking acetaminophen for pain病人同時服用乙醯胺酚（acetaminophen）止痛
華法林（Warfarin）是一種維生素 K 拮抗劑，透過影響凝血因子合成達到抗凝血效果。監測重點在於 INR 值（目標通常在 2.0-3.0，特定瓣膜置換可能更高）及出血徵兆。INR 過高代表出血風險極高。護理師需評估任何異常出血徵兆（如黏膜出血、血便、血尿），並在發現異常時立即通知團隊，評估是否需給予維生素 K 或暫停給藥。
Warfarin is a vitamin K antagonist that produces its anticoagulant effect by interfering with clotting factor synthesis. Monitoring focuses on the INR (target generally 2.0-3.0, possibly higher in specific valve replacements) and on signs of bleeding. An excessively high INR signifies a very high bleeding risk. The nurse must assess for any abnormal bleeding (such as mucosal bleeding, bloody stools, or hematuria) and notify the team immediately upon any abnormal finding to determine whether vitamin K should be given or the dose held.
台灣醫院常規對 Warfarin 病人衛教較嚴格，有時會建議避開深綠色蔬菜。美國教導則強調「Consistent intake」（規律穩定攝取），因為完全避免反而會導致 INR 波動更大。