A nurse is preparing to administer warfarin to a client who has chronic atrial fibrillation. Which of the following laboratory values should the nurse monitor prior to administering the medication?

Choice A Reason:

Positive Trousseau's sign is incorrect. Trousseau's sign is associated more with calcium imbalances, particularly hypocalcemia, and is assessed by inflating a blood pressure cuff on the arm to induce carpal spasm. It's not a specific indicator of metabolic acidosis related to high glucose levels in diabetes mellitus.

Choice B Reason:

Dizziness upon standing is incorrect. Dizziness upon standing, also known as orthostatic hypotension, is more commonly associated with blood pressure changes upon position changes. While it can occur in various conditions, it's not a specific indicator of metabolic acidosis in this context.

Choice C Reason:

Tingling of the fingers is incorrect. Tingling sensations, known as paresthesia, can occur due to various reasons, including nerve damage related to chronic high blood sugar levels in diabetes (diabetic neuropathy). However, it's not a direct and specific indicator of metabolic acidosis caused by high glucose levels in diabetes mellitus.

Choice D Reason:

Increased respiratory rate is correct. Metabolic acidosis in a diabetic individual can trigger compensatory mechanisms, such as increased respiratory rate (Kussmaul respirations), as the body tries to eliminate excess acids through respiration to help regulate the acid-base balance. This increased respiratory rate is an attempt to blow off carbon dioxide (a potential acidic byproduct) and decrease the acidity in the blood.

Choice A Reason:

Temperature 37.3°C (99.1°F) is incorrect . While a slightly elevated temperature can sometimes accompany an infection, it's not specific to a bladder infection and might not be present in all cases.

Choice B Reason:

Changed mental status is incorrect. Bladder infections or urinary tract infections (UTIs) in older adults can often present with atypical symptoms, and changes in mental status or acute confusion are common indicators in this population. UTIs can cause subtle but significant alterations in mental function, particularly in the elderly, leading to confusion, agitation, or cognitive impairment.

Choice C Reason:

WBC count 9,000/mm3 (5000 to 10,000/mm3) is incorrect .A WBC count within the normal range doesn't necessarily rule out or confirm a bladder infection. In some cases, UTIs might not significantly elevate the white blood cell count, especially in localized infections.

Choice D Reason:

Diminished reflexes is incorrect . Diminished reflexes are not typically associated with a bladder infection. They might indicate other neurological or muscular issues but are not a common sign of a UTI.