— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師向病人說明華法林（Warfarin）的使用注意事項。哪些內容是必要的？（多選）
A nurse is educating a client on the use of warfarin. Which instructions are essential? (Select all that apply.)
- AMaintain a consistent intake of leafy green vegetables✓ 正解保持葉菜類蔬菜攝取量一致
- BReport any unexplained bruising or nosebleeds✓ 正解報告任何不明原因的瘀青或鼻出血
- CUse a soft-bristled toothbrush to prevent gum bleeding✓ 正解使用軟毛牙刷以防止牙齦出血
- DIncrease aspirin intake if bruising occurs若發生瘀青則增加阿斯匹靈攝取量
- ECarry a medical alert identification card✓ 正解攜帶醫療警示識別卡
— Explanation · 中文詳解 —
華法林透過抑制維生素 K 依賴性凝血因子發揮作用。綠色蔬菜含有大量維生素 K，攝取量需穩定以免影響藥效。此外，由於藥物影響凝血功能，需採取抗出血措施，並隨身攜帶醫藥卡以防發生意外時醫療人員能迅速評估抗凝血風險。
Warfarin acts by inhibiting vitamin K-dependent clotting factors, so maintaining a consistent intake of leafy greens prevents unstable INR levels due to fluctuating vitamin K consumption. Because the drug impairs coagulation, clients must report unexplained bruising or bleeding and use soft-bristled toothbrushes to minimize mechanical trauma. Carrying medical alert identification ensures emergency responders can quickly identify the anticoagulation therapy.
✦ 台美臨床差異
台灣門診多透過衛教師或藥師協助監測 INR；美國則常有專門的 Anticoagulation Clinic 負責劑量調整。