— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師指導一位房顫病人服用華法林（Warfarin）。病人說出何種話語代表其理解藥物安全性？
A nurse is teaching a client about taking warfarin for atrial fibrillation. Which statement by the client indicates an understanding of the medication's safety?
- AI will use a soft-bristled toothbrush for oral hygiene✓ 正解我會使用軟毛牙刷進行口腔清潔
- BI can take aspirin if I develop a mild headache如果我出現輕微頭痛，我可以服用阿斯匹靈
- CI will increase my intake of dark green leafy vegetables我會增加深色葉菜類的攝取量
- DI will stop taking the medication if I see small bruises如果我看到小塊瘀青，我會停止用藥
— Explanation · 中文詳解 —
Warfarin 為抗凝血劑，會增加出血風險。使用軟毛牙刷可預防牙齦出血，這顯示病人具備預防出血之基礎安全認知。飲食需穩定而非增加深綠色蔬菜（含維生素 K），以免與藥物機轉產生交互作用；非處方藥如阿斯匹靈會加重出血風險，需避免；輕微瘀青屬副作用但非停藥指徵。
Warfarin is an anticoagulant that increases the risk of bleeding, so using a soft-bristled toothbrush helps prevent gum trauma and hemorrhage. Patients should maintain consistent vitamin K intake rather than increasing it, avoid aspirin due to bleeding risks, and report significant bleeding rather than stopping the medication for minor bruises.
✦ 台美臨床差異
美國有針對 Warfarin 監測的專科門診（Anticoagulation Clinic），台灣目前多由心臟內科醫師或藥師門診共同照護。