對於服用華法林 (Warfarin) 的病人，哪些護理措施是適當的？（選所有適合的）
Which nursing interventions are appropriate for a client taking Warfarin? (Select all that apply.)
- AMonitor INR results regularly✓ 正解定期監測 INR 結果
- BMaintain a consistent intake of green leafy vegetables✓ 正解維持綠色葉菜攝取量一致
- CInstruct the patient to avoid soft-bristled toothbrushes指示病人避免使用軟毛牙刷
- DAssess for signs of bleeding such as hematuria✓ 正解評估是否有血尿等出血徵象
- ELimit intake of Vitamin K-rich foods限制富含維生素 K 食物的攝取
華法林 (Warfarin) 是一種維生素 K 拮抗劑，透過抑制肝臟合成依賴維生素 K 的凝血因子（II, VII, IX, X）來發揮抗凝作用。護理重點在於平衡飲食與藥物監測，以維持治療性 INR 值。飲食中攝取穩定的維生素 K 至關重要，避免波動導致藥效失效或出血。此外，護理師需密切觀察出血徵象，並指導病人進行安全防護，如使用軟毛牙刷以避免牙齦損傷。
Warfarin therapy requires regular INR monitoring to ensure therapeutic levels and maintain a consistent intake of vitamin K-rich foods to prevent fluctuations in anticoagulation effects. Nurses should assess for signs of bleeding, such as hematuria, and instruct patients on safety measures like using soft-bristled toothbrushes to minimize trauma. Avoiding sudden changes in vitamin K consumption helps stabilize the medication's efficacy.
台美在華法林衛教上一致，重點皆在於「一致性攝取維生素 K」而非「禁食」。美國臨床常使用護理師處方流程 (Nursing Protocol) 根據 INR 值調整劑量，台灣則多由醫師親自調整。