A nurse is assisting in planning care for a 16-year-old client in a pediatric clinic. Which of the following actions would be a breach of confidentiality?

A. Psychologist: A psychologist focuses on mental health assessment and therapy rather than medication management. While they are essential for emotional and psychological support, they are not trained to evaluate or address potential drug interactions in a client's medication regimen.

B. Advanced practice nurse: An advanced practice nurse, such as a nurse practitioner, has the education and authority to assess medication regimens, recognize potential drug interactions, and make adjustments or recommendations. They are well-qualified to manage complex medication issues and collaborate closely with prescribing providers.

C. Patient care technician: Patient care technicians assist with basic care activities such as hygiene, mobility, and vital signs monitoring but do not have the education or licensure required to evaluate medications. They are not involved in clinical decision-making regarding pharmacologic therapy.

D. Social worker: A social worker provides resources for social support, financial assistance, and counseling, but medication management is outside their scope of practice. They are valuable for holistic care but not for assessing or managing drug interactions specifically.

Rationale:

A. Triiodothyronine: Triiodothyronine (T3) measures thyroid function and is not related to anticoagulation therapy. It is important for evaluating thyroid disorders but has no role in monitoring the effects of warfarin.

B. Arterial blood gases: Arterial blood gases (ABGs) assess oxygenation, ventilation, and acid-base balance, not anticoagulation status. ABGs are not used to monitor warfarin therapy.

C. Serum potassium: Serum potassium levels are crucial for cardiac and muscle function but are not affected directly by warfarin use. Potassium monitoring is more critical with diuretics or certain cardiac medications, not anticoagulants like warfarin.

D. Prothrombin time: Prothrombin time (PT) measures how long it takes blood to clot and is directly affected by warfarin therapy. Monitoring PT (and the related INR) ensures that the warfarin dose maintains therapeutic anticoagulation without causing excessive bleeding.