An obese, menopausal woman is beginning warfarin (Coumadin) therapy. Which adverse effect should you monitor this patient for in the first 10 days of drug therapy?

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Obese, menopausal women have an increased risk for developing skin necrosis as an adverse effect when starting warfarin therapy. This is due to their increased body weight and decreased production of endogenous estrogen, which can lead to lower protein C and S levels, making them more susceptible to clotting. Skin necrosis typically presents within the first 10 days of therapy and is characterized by painful, purplish lesions that can progress to skin necrosis and ulceration. Close monitoring of skin integrity is crucial during the initiation of warfarin therapy in this population.

An Obese, Menopausal Woman Is Beginning Warfarin (Coumadin) Therapy