A nurse is caring for a client who has cirrhosis of the liver and is receiving spironolactone. Which of the following findings indicates that the client is responding to the treatment?

A) PTT (Partial Thromboplastin Time): While the PTT is a laboratory test used to assess the intrinsic pathway of the coagulation cascade and monitor the effectiveness of heparin therapy, it is not routinely used to monitor warfarin therapy. Therefore, reviewing the PTT prior to administering warfarin is not necessary.

B) PT (Prothrombin Time): Prothrombin time measures the extrinsic pathway of the coagulation cascade and is commonly used to monitor warfarin therapy. Since warfarin works by inhibiting vitamin K-dependent clotting factors, such as factors II, VII, IX, and X, monitoring the PT allows for the assessment of the anticoagulant effect of warfarin and helps guide dosing adjustments. Therefore, reviewing the PT prior to administering warfarin is essential to ensure appropriate anticoagulation therapy.

C) WBC (White Blood Cell Count): The white blood cell count is not directly related to warfarin therapy monitoring. While an elevated white blood cell count may indicate infection, it is not specific to warfarin therapy and does not influence the administration of the medication.

D) Total iron-binding capacity: Total iron-binding capacity is a laboratory test used to assess iron status and is not relevant to monitoring warfarin therapy. It measures the body's ability to bind and transport iron in the blood, and its results are not indicative of warfarin's anticoagulant effect or dosage adjustments.

A) Ask another nurse to check the medication dosage prior to administration: While double-checking medication dosages with another nurse can be a part of the medication safety process, it primarily ensures the right dose rather than confirming the right medication. This action focuses on the right dose rather than the right medication.

B) Use two client identifiers prior to administering the medication: This action aligns with the principles of medication safety and the "five rights" of medication administration, which include the right patient. Using at least two client identifiers, such as name and date of birth, helps ensure that the medication is being administered to the correct patient, which is essential for preventing errors related to patient misidentification.

C) Document the full name of the prescribed medication after administration: While accurate documentation is important for maintaining a complete record of medication administration, documenting the full name of the medication after administration does not directly ensure that the right medication was administered beforehand. It is a step in the documentation process but does not specifically address the verification of the medication before administration.

D) Verify a written order with the medication administration record: Verifying a written order with the medication administration record helps ensure that the correct medication is being administered as prescribed by the healthcare provider. However, this action focuses on confirming the accuracy of the prescription rather than confirming the right medication immediately before administration.