一位病人正在接受 warfarin 治療。護理師應對病人進行哪些潛在不良反應的衛教？（選所有適合的）
A client is receiving warfarin. The nurse should educate the client about which potential adverse effect? (Select all that apply.)
- AEasy bruising✓ 正解容易出現瘀青
- BFrequent urination頻尿
- CBleeding gums✓ 正解牙齦出血
- DShortness of breath呼吸困難
- EBlood in stool✓ 正解糞便帶血
Warfarin 是一種維生素 K 拮抗劑，透過抑制凝血因子 II、VII、IX、X 的合成來發揮抗凝血作用。由於凝血能力下降，病人發生異常出血的風險大幅增加。護理重點在於教導病人自我監測出血徵兆，並落實安全防護措施。正確選項反映了常見的出血表現：皮下微血管破裂導致的瘀傷 (A)、黏膜脆弱導致的牙齦出血 (C)，以及腸胃道潛在出血引發的黑便 (E)。
Warfarin is a vitamin K antagonist that exerts its anticoagulant effect by inhibiting the synthesis of clotting factors II, VII, IX, and X. Because clotting ability decreases, the patient's risk of abnormal bleeding rises substantially. Nursing priorities focus on teaching the patient to self-monitor for signs of bleeding and to implement safety precautions. The correct options reflect common bleeding manifestations: bruising caused by capillary rupture under the skin (A), gum bleeding from fragile mucous membranes (C), and black tarry stools (melena) caused by potential gastrointestinal bleeding (E).
在美國臨床實務中，病人常需居家自我監測 INR (International Normalized Ratio) 並定期回診。衛教重點強調「出血警訊」以及「飲食中維生素 K 的攝取一致性」，而非完全禁食深綠色蔬菜。