A nurse is reviewing the laboratory results of a client who has atrial fibrillation and a prescription for warfarin. After informing the provider that the INR is 2.5, the nurse should expect which of the following prescriptions?

Choice A Reason:
Dark amber urine is incorrect. Dark urine can indicate concentrated urine, often seen in dehydration when the body is trying to conserve water.
Choice B Reason:
Decreased skin turgor is incorrect. Decreased skin turgor is a classic sign of dehydration, indicating that the skin lacks elasticity due to insufficient fluid intake or loss.
Choice C Reason:
Pink, frothy sputum is correct. Normal saline is a common intravenous solution used to treat dehydration. However, in some cases, especially when administered in excessive amounts, it can lead to fluid overload or pulmonary edema. This can manifest as pink, frothy sputum, indicating potential pulmonary congestion or edema, which is a serious adverse effect of fluid overload.
Choice D Reason:
Increased bowel sounds is incorrect. Increased bowel sounds can be seen in various conditions, including gastrointestinal disturbances or hyperactive bowel motility, but it's not typically associated with the adverse effects of normal saline administration.

Choice A Reason:
Hypomagnesemia is incorrect. Lithium therapy itself is not a direct cause of hypomagnesemia. While exercise can affect magnesium levels to some extent, it's not a primary electrolyte imbalance that is typically associated with lithium use or considered a significant concern specifically due to lithium.
Choice B Reason:
Hypocalcemia is incorrect. Similarly, lithium therapy is not a direct cause of hypocalcemia. Exercise can affect calcium metabolism, but it's not a primary electrolyte imbalance typically associated with lithium use or considered a significant concern specifically due to lithium.
When a client taking lithium begins a new exercise program, the nurse should primarily assess for the risk of:
Choice C Reason:
Hyponatremia is correct. Lithium can affect the body's regulation of sodium, and excessive sweating due to increased exercise can lead to sodium loss. This combination can potentially contribute to the development of hyponatremia (low sodium levels). Therefore, when a client on lithium starts a new exercise regimen that may induce sweating, monitoring for signs of hyponatremia becomes crucial. Symptoms of hyponatremia can include confusion, headaches, nausea, and in severe cases, seizures or coma.
Choice D Reason:
Hypokalemia is incorrect. Lithium itself does not commonly cause hypokalemia. Exercise can lead to potassium loss through sweating, but hypokalemia is not the primary electrolyte imbalance typically associated with lithium use or considered a significant concern specifically due to lithium.