A nurse is caring for a client who has a prescription for warfarin.

Which of the following laboratory tests should the nurse monitor?

Choice A Reason:

Chloasma is incorrect. Chloasma, also known as the "mask of pregnancy," refers to the brownish or tan patches of pigmentation that can appear on the face during pregnancy. It is not related to the purplish discoloration of the cervix, vagina, and vulva described in the scenario.

Choice B Reason:

Hegar's sign is incorrect. Hegar's sign is a softening and compressibility of the lower uterine segment (the area between the cervix and the body of the uterus) that can be felt during a pelvic examination. It is not related to discoloration of the genital area.

Choice C Reason:

Ballottement is incorrect. Ballottement is a technique used during a pelvic examination to assess the fetus's position and is characterized by the examiner feeling a rebound movement of the fetus when it is pushed and then released. It does not involve discoloration of the genital area.

Choice D Reason:

Chadwick's sign is a bluish-purple or purplish discoloration of the cervix, vagina, and vulva that can occur during pregnancy. This discoloration is due to increased blood flow to the pelvic area and is considered a normal physiological change during pregnancy. It is one of the early signs of pregnancy and can be observed as early as the sixth week of gestation. It is named after the American obstetrician James Read Chadwick, who first described it.

Choice A Reason:

The client wanting to talk about the diagnosis with nursing staff indicates a desire for communication and support, which may be an expression of hope or a way to cope with the diagnosis.

Choice B Reason:

Requesting a second opinion suggests that the client is actively seeking more information and exploring potential treatment options, which is not indicative of hopelessness.

Choice C Reason:

Having a decreased energy level can be a common physical and emotional response to a terminal illness but does not directly indicate hopelessness on its own. It may reflect the physical and emotional toll of the diagnosis and its treatment.

Choice D Reason:

The client makes funeral arrangements is correct. Making funeral arrangements is often seen as an indication of hopelessness in the context of a recent terminal illness diagnosis. It suggests that the client has accepted the inevitability of their death and is preparing for it. While making arrangements can be a practical and important step, it may also indicate a sense of hopelessness or resignation.