A nurse is caring for a client who has prescriptions for furosemide and gentamicin. For which of the following complications should the nurse monitor the client?

Rationale:

A. "Use an electric razor when shaving while taking this medication.": Warfarin is an anticoagulant that increases the risk of bleeding. Using an electric razor reduces the risk of cuts and subsequent bleeding, which is an important safety measure for clients on warfarin therapy.

B. "Take a dose of the medication every 5 minutes for a maximum of three doses": This instruction is inappropriate and unrelated to warfarin. Warfarin is taken orally once daily, and frequent dosing in short intervals could lead to serious bleeding complications.

C. "Avoid taking this medication with milk products.": Milk does not significantly affect warfarin absorption or activity. The client should be cautioned about foods high in vitamin K, such as leafy greens, because they can interfere with warfarin’s anticoagulant effect.

D. "This medication can cause hearing loss.": Hearing loss is not a known adverse effect of warfarin. The primary concerns are bleeding risks, bruising, and interactions with other medications or foods.

Rationale:

A. Explain the cast application procedure to the child: Preparing the child for a future procedure is helpful but not immediately necessary. At this point, pain control and reduction of swelling take precedence to prevent complications and stabilize the injury.

B. Review cast care instructions with the child's parents: While parent education is important, it is secondary to immediate interventions that address pain, swelling, and preparation for the procedure. Priority actions focus first on the child’s current needs and safety.

C. Elevate the affected forearm with pillows: Elevation helps reduce edema and pain in the fractured extremity and prevents further swelling. This is a critical nursing intervention for acute fracture management before and after casting.

D. Apply ice packs to the fingers and along the right forearm: Ice helps manage pain and inflammation by vasoconstriction, limiting fluid accumulation in tissues. Applying it early post-injury is crucial to controlling swelling in a fractured limb.

E. Place a nonadherent dressing on the right knee abrasion: Caring for minor abrasions is important but is not a priority compared with interventions addressing fracture management, pain, and preparation for cast application.

F. Administer Ibuprofen 200 mg PO: Pain management is a priority in fracture care to maintain comfort and reduce distress. Administering analgesics before cast application helps the child tolerate the procedure and facilitates cooperation.