A nurse is caring for a client who is receiving high-dose metalopramide. The nurse should monitor the client for which of the following adverse effects?

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) The client will wear his reading glasses when drawing up a dose of insulin glargine: This is the correct expected outcome. Older adults may experience visual changes that affect their ability to see clearly. Wearing reading glasses or using other visual aids can help ensure accurate measurement and administration of insulin glargine, reducing the risk of dosing errors.

B) The client will administer insulin glargine before each meal: This statement is incorrect. Insulin glargine is a long-acting insulin analog that is typically administered once daily at the same time each day, rather than before each meal. It provides a steady level of insulin over a 24-hour period and is not directly related to meal timing.

C) The client will use the deltoid muscle as an injection site: Using the deltoid muscle as an injection site for insulin glargine is not recommended. Insulin glargine is usually injected suIcutaneously into the abdomen, thigh, or upper arm. The deltoid muscle may not provide consistent absorption of insulin and is not commonly used for insulin injections.

D) The client will take an additional dose of insulin glargine prior to exercise: Taking an additional dose of insulin glargine prior to exercise is not a typical part of insulin glargine therapy. Adjustments to insulin doses for exercise should be made under the guidance of a healthcare provider, and additional doses of insulin glargine are not usually recommended for this purpose.