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Case Study

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 international normalized ratio; 1000-mg fish oil supplements; one multivitamin; and Pepcid, 10 mg once a day.

Which substances should you be concerned with at this time?
The patient asks which medications she should take the day of the procedure. How should you advise this patient?
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?

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