An older adult client brought to the emergency department for bloody stools has been taking warfarin (Coumadin) post stroke. Initial diagnostic lab work reveals warfarin to be within therapeutic range. The daughter asks why the client has bloody stools if the lab work is normal. Which responses by the nurse are appropriate?

Question

Quizplus · Accepted Answer

Rationale 1: Liver function declines during the aging process.
Rationale 2: As liver function declines, so does the production of plasma proteins.
Rationale 3: As the production of plasma proteins declines, an increase in highly protein-bound drugs results in higher concentrations of free drug.
Rationale 4: Decreased plasma proteins lead to fewer binding sites, resulting in higher, not lower, concentrations of free drug.
Rationale 5: The decrease in liver function and plasma proteins may cause the adverse effects of bleeding and bloody stools. It does not have anything to do with the blood-brain barrier.

An Older Adult Client Brought to the Emergency Department for Bloody