A nurse is planning care for a group of clients following change-of-shift report. When using clinical decision making, which of the following clients should the nurse assess first?

A) Orthostatic hypotension:
Tamsulosin, an alpha-blocker used to treat benign prostatic hypertrophy, can cause orthostatic hypotension, which is a significant adverse effect. This condition involves a sudden drop in blood pressure when standing up, leading to dizziness or fainting. It's important for clients to report these symptoms to their healthcare provider for potential adjustment of medication or additional instructions on managing this side effect.

B) Muscle tenderness:
Muscle tenderness is not commonly associated with tamsulosin. While muscle pain can occur with other medications, it is not a known adverse effect of tamsulosin and does not require immediate notification to the provider in the context of this medication.

C) Decreased heart rate:
Tamsulosin does not typically cause bradycardia (decreased heart rate). This side effect is more associated with beta-blockers or other cardiac medications, rather than alpha-blockers like tamsulosin. Reporting this would be relevant for those other medications but not for tamsulosin.

D) Oliguria:
Oliguria, or decreased urine output, is not a known adverse effect of tamsulosin. Tamsulosin helps improve urine flow in clients with benign prostatic hypertrophy, so reporting oliguria would not be pertinent in this context. Instead, it could indicate another underlying issue.

A) Cleanse the client's finger with an antiseptic swab: The first step in performing a capillary blood glucose test is to cleanse the client’s finger with an antiseptic swab. This reduces the risk of infection and ensures that any contaminants on the skin do not affect the accuracy of the blood glucose reading.

B) Hold the client's finger in a dependent position: Holding the finger in a dependent position can help increase blood flow, but this step is taken after cleansing the finger. The priority is to first clean the area to minimize the risk of infection.

C) Wipe away the first drop of blood: Wiping away the first drop of blood is done to avoid contamination from interstitial fluid and to ensure a more accurate reading. However, this action occurs after the blood sample is obtained, not before the test begins.

D) Place the lancet on the side of the selected finger: While placing the lancet on the side of the finger is important for minimizing discomfort and obtaining an adequate blood sample, it follows the initial steps of cleaning the finger and preparing for the blood draw.