The nurse evaluates that the client understood discharge teaching regarding warfarin (Coumadin) based on which statement?

• A. "I will double my dose if I forget to take it the day before."
• B. "I should keep taking ibuprofen for my arthritis."
• C. "I should decrease the dose if I start bruising easily."
• D. "I should use a soft toothbrush for dental hygiene."

Answer: (D)

Minimizing bleeding risk while on warfarin. Using a soft toothbrush shows the patient understands how to reduce mucosal trauma and bleeding during daily care, which is essential because warfarin slows clotting and even small gum injuries can bleed more than usual. This choice reflects proper bleeding risk management during oral hygiene.

The other statements reveal common misconceptions: not doubling a dose after a missed dose is dangerous because it can lead to excessive anticoagulation and serious bleeding; taking ibuprofen is risky since NSAIDs increase bleeding risk and can interact with warfarin—acetaminophen is a safer alternative for pain; and trying to decrease the dose because of easy bruising is not appropriate self-management—dose changes require clinician guidance.