After reviewing the resources in the Weekly Guide/Week 2, identify a clinical problem within the nurse’s practice setting related to patient care. The nurse currently does not provide any direct, hands-on patient care; instead, the nurse educates patients for health related issues over phones. The nurse notices that one of her patients, an 89-year-old male, takes Warfarin, an anticoagulant therapy, after a cardiovascular disease was diagnosed. Warfarin inhibits the enzyme vitamin K epoxide reductase to prevent the reduction of vitamin K, which is a step necessary for activation of clotting factors II, VII, IX, and X (Van Berkel, Crannage, & Murphy, 2013). The patient follows the doctor’s recommendation for completing blood work to ensure the medication is consistently within the therapeutic level. Therefore, the International Normalized Ratio (INR), prothrombin time …show more content…
Discuss how the clinical question would guide the nurse’s search strategy to address the issue and implement a change in practice. This well-built clinical question will guide the nurse to search the keywords or their combination to narrow down the research. The keywords may include “anticoagulant therapy”, “warfarin toxicity”, “dietary management”, and “vitamin K administration”. Once the peer-reviewed journals and articles that contain these keywords are located, the nurse will review the evidence based practice. This will help the nurse to evaluate the evidence supporting the question and understand the pros and cons of using vitamin K and dietary management to maintain the INR level within the normal range. References Chang, C., Wang, Y., Liu, P. Y., & Yang, Y. K. (2014). A practical approach to minimize the interaction of dietary vitamin K with Warfarin. Clinical Pharmacy and Therapeutics, 39(1),