A nurse is caring for a client who is receiving warfarin 5 mg PO daily. Which of the following laboratory values should the nurse check prior to administering the medication? (Select all that apply.)

BUN

Serum potassium

Serum sodium

INR

Answer and Explanation

Correct Answer : C,E

A. BUN: Blood urea nitrogen is a marker of renal function and is not directly affected by warfarin therapy. While renal function is important for overall medication safety, it does not guide warfarin dosing or anticoagulation monitoring.

B. Serum potassium: Potassium levels are important for cardiac and neuromuscular function but are not influenced by warfarin. Monitoring potassium is unrelated to evaluating the effectiveness or safety of warfarin therapy.

C. PT: Prothrombin time measures the extrinsic and common coagulation pathways, which are directly affected by warfarin. Checking PT before administration helps assess anticoagulation status and the risk of bleeding, allowing for appropriate dose adjustments.

D. Serum sodium: Sodium levels are critical for fluid balance and neurologic function but do not affect warfarin therapy or coagulation. Monitoring sodium is not necessary for safe administration of warfarin.

E. INR: International normalized ratio standardizes PT results to guide warfarin therapy safely. It provides a reliable measure of anticoagulation and bleeding risk, and checking INR before administering warfarin ensures the dose is appropriate for therapeutic anticoagulation.

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Correct Answer is A

Explanation

A. Potassium: Furosemide is a loop diuretic that increases renal excretion of sodium, chloride, and water, which can lead to significant potassium loss. Monitoring serum potassium levels is essential to prevent hypokalemia, which can cause muscle weakness, arrhythmias, and cardiac complications, especially in infants who are more vulnerable to electrolyte imbalances.

B. WBC count: Furosemide does not typically affect white blood cell production or immune function. Monitoring WBC count is not indicated solely for furosemide therapy unless the infant has another condition that requires hematologic surveillance.

C. Iron: Furosemide does not interfere with iron metabolism or absorption. Iron studies are unrelated to diuretic therapy and are not required unless the infant has known anemia or is receiving iron supplementation for another reason.

D. Amylase: Amylase is a pancreatic enzyme monitored in cases of pancreatic disorders or suspected pancreatitis. Furosemide therapy does not directly affect pancreatic function, so amylase measurement is not indicated as part of routine monitoring for this medication.

A. Sickle-cell anemia B. Herpes zoster C. Community-acquired pneumonia D. Viral meningitis

Correct Answer is A

Explanation

A. Sickle-cell anemia: Clients with sickle-cell anemia who are not actively infected do not pose an infectious risk, making them suitable roommates for an immunocompromised client receiving chemotherapy. Cohorting noninfectious clients together minimizes exposure to pathogens while allowing safe shared accommodations.

B. Herpes zoster: Active shingles (herpes zoster) is contagious, particularly to immunocompromised individuals. Sharing a room would place the client with Hodgkin’s disease at high risk for contracting a serious infection, which could lead to severe complications.

C. Community-acquired pneumonia: Pneumonia can be caused by bacteria or viruses and is transmissible through respiratory droplets. Placing an immunocompromised client with a person who has pneumonia increases the risk of infection, so it is not appropriate for room sharing.

D. Viral meningitis: Viral meningitis is contagious, and an immunocompromised client is highly susceptible to infection. Cohorting with a client who has viral meningitis would put the client with Hodgkin’s disease at significant risk for acquiring the illness.

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A nurse is caring for a client who is receiving warfarin 5 mg PO daily. Which of the following laboratory values should the nurse check prior to administering the medication? (Select all that apply.)

Nursing Test Bank

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