A nurse is caring for a client who has a prescription for warfarin. Which of the following laboratory tests should the nurse monitor?

a.Pancrelipase does not directly impact respiratory function. It is an enzyme replacement therapy used to aid digestion by compensating for the lack of pancreatic enzymes, not to improve lung function.

b.Cystic fibrosis affects sodium and chloride transport, leading to higher sodium levels in sweat. However, pancrelipase does not affect sodium excretion; it focuses on aiding digestion.

c.Pancrelipase helps with the digestion and absorption of fats and fat-soluble vitamins (A, D, E, K). Vitamins B and C are water-soluble and are not typically affected by the enzyme therapy used for fat digestion.

d.This is the correct answer. Pancrelipase contains enzymes (lipase, protease, and amylase) that help break down fats, proteins, and carbohydrates. In cystic fibrosis, pancreatic enzyme production is often insufficient, leading to malabsorption and steatorrhea (excessive fat in the stools). By providing the necessary enzymes, pancrelipase helps improve the digestion and absorption of dietary fats, reducing the fat content in the stools.

This response allows the nurse to actively listen to the client, gain a better understanding of their concerns and reasons behind wanting to stop treatment, and open the door for a more in-depth conversation. It demonstrates a non-judgmental approach and creates an opportunity for the client to express their fears, concerns, or any other factors influencing their decision.

"I would feel the same way if I were you." This response reflects the nurse's personal opinion and may not accurately represent the client's thoughts or feelings. It does not encourage the client to explore their own feelings or provide an opportunity for open communication.

"Why do you think that would be a good choice?" This response may come across as confrontational and judgmental, potentially making the client defensive or shutting down communication. It does not facilitate a therapeutic conversation or encourage the client to express their emotions and concerns openly.

"You'll be cancer-free after you complete your treatments." This response may oversimplify the client's situation or offer false reassurance. It is important to acknowledge the client's feelings and concerns while providing accurate information and support, rather than making unrealistic promises about treatment outcomes.

The nurse should approach the client's expression of wanting to stop treatment with empathy, active listening, and an open mind to provide the necessary support, education, and resources to help the client make informed decisions about their healthcare.