— 降低風險 · MEDIUM · SATA —
護理師對服用華法林（Warfarin）的病人進行衛教。下列哪些敘述表示病人需要進一步指導？（選所有適合的）
A nurse is teaching a client about warfarin therapy. Which statements by the client indicate a need for further teaching? (Select all that apply.)
- AI will increase my intake of green leafy vegetables.✓ 正解我會增加綠色葉菜類的攝取
- BI will use a soft-bristled toothbrush for oral care.我會使用軟毛牙刷進行口腔護理
- CI will notify my doctor if I notice black, tarry stools.如果我注意到黑色柏油樣糞便，我會通知醫生
- DI will take an extra dose if I miss one the previous day.✓ 正解如果前一天漏服，我會多服用一劑
- EI will report any sudden severe headache to the provider.我會向醫療提供者報告任何突發的劇烈頭痛
— Explanation · 中文詳解 —
華法林衛教重點：深綠色蔬菜含有維生素 K，會抵消藥效，需攝取穩定而非增加；漏服藥物不可補服雙倍劑量以免出血風險。B、C、E 皆為正確認知，包括出血預防與警訊辨識。病人若認為應增加綠色蔬菜或擅自補藥，代表認知錯誤。
Increasing intake of green leafy vegetables requires further teaching because vitamin K can decrease warfarin's effectiveness, and consistency is key rather than sudden increases. Additionally, taking an extra dose to make up for a missed one is dangerous as it significantly increases the risk of bleeding; doses should never be doubled.
✦ 台美臨床差異
美台對 Warfarin 的飲食衛教重點一致，但在台灣臨床較常建議病人與營養師諮詢，避免自行大幅調整飲食結構。