— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位病人正處方 Warfarin（抗凝血劑）治療。哪項出院衛教內容最重要？
A patient is prescribed warfarin therapy. Which nursing instruction is most important for discharge teaching?
- ATake aspirin if headache occurs若頭痛發生時服用阿斯匹靈
- BAvoid eating green leafy vegetables避免食用綠色葉菜類蔬菜
- CMaintain a consistent intake of vitamin K-rich foods✓ 正解維持攝取富含維生素 K 的食物量一致
- DIncrease intake of cranberry juice增加蔓越莓汁的攝取量
— Explanation · 中文詳解 —
Warfarin 的機轉是拮抗維生素 K。衛教關鍵並非「完全禁止」攝取綠色蔬菜，而是維持「穩定」攝取量，以免維生素 K 波動導致 INR 數值不穩定。B 錯誤因為過度限制會導致營養不均；D 與 A 會影響凝血功能，增加出血風險。
Warfarin functions as a vitamin K antagonist, so the key to safe discharge teaching is maintaining a consistent intake of vitamin K-rich foods rather than avoiding them entirely. Fluctuations in vitamin K consumption can cause unstable International Normalized Ratio (INR) levels, compromising therapeutic efficacy. Patients should also avoid aspirin and cranberry juice, as these increase bleeding risk or interact with warfarin metabolism.
✦ 台美臨床差異
台美皆重視 Warfarin 之衛教，但在美國常有專責抗凝血診所（Anticoagulation Clinic）追蹤 INR。