67-year-old diagnosed with an irregular heart rhythm.  For the past month, she has been taking the following medications for management of her heart condition: Digoxin 0.25mg once daily Warfarin (Coumadin) 5mg once daily During her F/U visit, you notice that Mrs. Pender has developed purpura on her arms & lower legs.  When you ask her about these “purple spots” she states that she started noticing them about a week ago. The provider has ordered serum LFTs & renal function tests   1.Based on the knowledge of drug pharmacokinetics, how should the nurse explain to the patient the possible cause of the purpura? 2.Mrs. Pender’s renal function test results show mild kidney impairment.  What changes can the nurse anticipate regarding the patient’s medication regimen? 3.The patient asks the nurse, “Why did you have to check the function of my liver?”  What is the most appropriate response by the nurse?

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