— 降低風險 · MEDIUM · MCQ —
護理師指導一位服用華法林（Warfarin）的病人，下列哪項敘述顯示病人需要再教育？
A nurse is teaching a client about warfarin therapy. Which statement indicates the need for further education?
- AI will avoid contact sports我會避免參與接觸性運動
- BI will report any unusual bruising我會回報任何異常的瘀青
- CI will use a soft-bristled toothbrush我會使用軟毛牙刷
- DI will eat a large salad with dark leafy greens every day✓ 正解我每天都會吃一大盤深色葉菜沙拉
— Explanation · 中文詳解 —
華法林為維生素 K 拮抗劑。攝取大量深綠色蔬菜（富含維生素 K）會抵銷藥效，導致 INR 數值降低，影響抗凝血效果。因此，病人應保持維生素 K 攝取量穩定，而非過度攝取或完全不吃，此觀念若偏差即需再指導。
Warfarin is a vitamin K antagonist, so consuming large amounts of dark leafy greens can decrease its effectiveness by stabilizing or lowering INR levels. Clients should maintain a consistent vitamin K intake rather than fluctuating it, making this statement indicative of a need for further education.
✦ 台美臨床差異
美國藥師會針對飲食交互作用提供極詳細衛教，台灣則多由護理師負責衛教與 INR 監測提醒。