— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師給予華法林（Warfarin）時，哪些是適當的護理措施？（選所有適合的）
Which of the following are appropriate nursing actions when administering warfarin? (Select all that apply.)
- AMonitor the INR level as ordered✓ 正解依指示監測 INR 數值。
- BEducate the patient to maintain consistent green leafy vegetable intake✓ 正解教育患者維持一致的綠色蔬菜攝取量。
- CAdvise the patient to use a soft-bristled toothbrush✓ 正解建議患者使用軟毛牙刷。
- DIncrease intake of Vitamin K-rich foods增加富含維生素 K 食物的攝取。
- ECheck for signs of bleeding such as bruising or hematuria✓ 正解檢查是否有瘀青或血尿等出血跡象。
— Explanation · 中文詳解 —
Warfarin 透過抑制維生素 K 依賴性凝血因子產生藥效，INR 是監測指標。飲食中攝取維生素 K 的量需保持穩定，不可忽多忽少，以免影響抗凝血效果。出血預防包括避免外傷、使用軟毛刷，並監測皮膚瘀青或血尿等潛在出血徵象。
Warfarin therapy requires monitoring the INR to ensure therapeutic levels and maintaining a consistent intake of vitamin K-rich foods to prevent fluctuations in anticoagulation. Nursing actions also include advising the use of soft-bristled toothbrushes to minimize bleeding risk and assessing for signs of hemorrhage such as bruising or hematuria.
✦ 台美臨床差異
台灣門診病人常因衛教認知不足導致 INR 控制不佳；美國則有專門的抗凝血管理中心（ACMC）進行嚴格藥物監控。