A nurse is caring for a client who is receiving warfarin 5 mg PO daily. Which of the following laboratory values should the nurse check prior to administering the medication? (Select all that apply.)

A. "Call a shelter in another county.": While contacting a shelter can be part of a safety plan, specifying another county is not necessary unless there is a need for increased distance from the abuser. The instruction should be individualized, and calling local resources may be more immediately practical and safer.

B. "Leave your partner immediately.": Immediate departure is not always safe and may increase the risk of harm if done impulsively. Safety planning emphasizes strategic, well-thought-out actions rather than abrupt decisions that could escalate danger.

C. "Keep a packed bag by your front door.": Having a packed bag ready is a precautionary measure, but it is only effective if the client also has a safe, rehearsed plan and access to secure transportation. Without a concrete strategy, this step alone may not reduce risk effectively.

D. "Rehearse your escape route.": Practicing an escape route helps the client respond quickly and safely in an emergency situation. Rehearsal allows the client to identify safe exits, plan for transportation, and anticipate obstacles, which is a central component of an effective safety plan for partner violence.

A. "I will have general anesthesia during the procedure.": Thoracentesis is performed using local anesthesia to numb the puncture site, not general anesthesia. Local anesthesia allows the client to remain awake, follow breathing instructions, and reduce procedural risk associated with systemic sedation. General anesthesia is unnecessary and increases potential complications.

B. "I will lie flat for 6 hours following the procedure.": After a thoracentesis, clients are generally encouraged to resume normal positioning as tolerated, often sitting upright or semi-Fowler’s position. Prolonged flat positioning is not required and does not prevent complications. Monitoring focuses on respiratory status and observing for pneumothorax.

C. "I will have a chest x-ray following the procedure.": A post-procedure chest x-ray is standard to confirm lung re-expansion and to check for complications such as pneumothorax or hemothorax. This imaging ensures that the lung has not been punctured or collapsed during fluid removal, and it guides further management if abnormalities are detected.

D. "I will breathe deeply through my nose during the procedure.": Clients are usually instructed to sit upright and remain still, with occasional breath-holding at end-inspiration during needle insertion. Breathing deeply through the nose is not a standard instruction and may increase movement, risking needle trauma to lung tissue.