A woman with hypothyroidism has been taking levothyroxine (Synthroid) for 5 years. She has just been prescribed warfarin (Coumadin). The nurse immediately calls the health care provider to review these orders and anticipates the physician will

  1. order lab work.
  2. increase the dose of warfarin.
  3. discontinue the levothyroxine.
  4. decrease the dose of warfarin.
Number 1 is correct.
Rationale: Levothyroxine enhances the effects of warfarin, which could place patients at a higher risk for bleeding. A nurse should anticipate that the physician would evaluate the clotting time of the client more frequently and adjust the medication accordingly