A nurse is caring for a male client who has peripheral vascular disease (PVD), is taking dietary supplements, and has a new prescription for warfarin. The nurse should instruct the client to stop which of the following supplements prior to starting the warfarin? (Select all that apply.)

Choice A reason: Glucosamine may potentiate the effects of warfarin and increase the risk of bleeding. Though commonly used for joint health, its interaction with anticoagulants warrants caution and discontinuation prior to initiating warfarin therapy. Choice B reason: Flaxseed oil has antiplatelet properties and may increase bleeding risk when combined with warfarin. It is often used for cardiovascular health but should be avoided due to its potential to enhance anticoagulant effects. Choice C reason: Saw palmetto can inhibit platelet aggregation and may increase the risk of bleeding when taken with warfarin. It is typically used for prostate health but poses a safety concern in anticoagulated patients. Choice D reason: Gingko biloba is well-known for its antiplatelet effects and has been documented to increase bleeding risk when combined with warfarin. It should be discontinued to prevent hemorrhagic complications. Choice E reason: Black cohosh is primarily used for menopausal symptoms and does not have a strong documented interaction with warfarin. While caution is always advised with herbal supplements, it is not among the primary supplements contraindicated with warfarin.