— 降低風險 · MEDIUM · SATA —
護理師指導一位服用華法林 (Warfarin) 的病人出院。病人說出哪些話顯示需要進一步衛教？（選所有適合的）
A nurse is providing discharge instructions to a client with a new prescription for warfarin. Which statements by the client indicate a need for further teaching? (Select all that apply.)
- AI will take my medication at the same time each day我每天會在固定時間服藥
- BI will increase my intake of dark green leafy vegetables✓ 正解我會增加深色葉菜類的攝取
- CI will use a soft-bristled toothbrush for oral hygiene我會使用軟毛牙刷進行口腔清潔
- DI will use a straight razor to shave my face✓ 正解我會使用直刃刮鬍刀刮鬍
- EI will report any unusual bruising or bleeding to my doctor我會向醫師報告任何異常的瘀青或出血
— Explanation · 中文詳解 —
華法林透過對抗維生素 K 發揮抗凝血作用，深綠色蔬菜富含維生素 K，會抵銷藥效，應維持穩定攝取量而非增加。使用刮鬍刀容易造成皮膚割傷且難以止血，應建議使用電動刮鬍刀。每日固定時間服藥、軟毛牙刷及報告異常出血皆為正確的抗凝血治療護理行為。
Increasing intake of dark green leafy vegetables is incorrect because they are high in vitamin K, which antagonizes warfarin and reduces its anticoagulant effect. Additionally, using a straight razor is unsafe as it increases the risk of cuts and uncontrolled bleeding; an electric razor is recommended instead.
✦ 台美臨床差異
美國醫療系統對於 INR 控制有嚴格的衛教流程，台灣則常由藥師進行詳細的藥物諮詢並協助追蹤。