Question

Chapters 20-25
Lehne's Pharmacology for Nursing Care, 10th Edition
by Burchum DNSc APRN BC, Jacqueline (Author), Rosenthal DNP ACNP, Laura (Author)
ISBN-13: 978-0323512275 | ISBN-10: 0323512275

Ch 21 Case Study NAME_______________
You are the nurse in the same-day surgery center at a local hospital. You are assigned to call patients 2
days before their procedures to educate them and answer any questions they may have about their
upcoming procedures. Mrs. Smith is a 65-year-old woman who will be coming in to have her gallbladder
removed (cholecystectomy) in 2 days. You obtain a full history on the patient and find she has the
following medications prescribed: Coumadin, 2-mg dose according to INR; 1000-mg fish oil supplements;
one multivitamin; and Pepcid, 10 mg once a day.
1. Which substances should you be concerned with at this time?
Answer:
Rationale:
2. The patient asks which medications she should take the day of the procedure. How should you
advise this patient?
Answer:
Rationale:
3. The patient has the procedure and is ready to be discharged. You are discussing diet and drug-food
interactions with the patient. Based on the patient’s medication profile, how will you advise this
patient?
Answer:
Rationale:

Answer 1

1. The medication which is of utmost concern is warfarin because it is an anticoagulant and it should be stopped 5 days prior to surgery to avoid excessive hemorrhage

2. The medication she should take the day of the procedure is pepcid which is an antacid along with small sips of water . All other medications should be stopped and she should be NPO from the midnight.

3. Based on the medication profile :

Pepcid , multivitamin and fishoil does not have any food interaction .

#. Advice her to avoid these food items along with warfarin because these inhibits Warfarin

-liver

-broccoli

-brussel sprouts

-cabbage

-rocket or arugula salad

-kale

-spinach

-swiss chard

-watercress

-squash

-mung beans

-mushrooms

-soybeans

-rapeseed oil

-large amounts of avocado

-soy milk/sushi containing seaweed

-high protein/low carb diet