A nurse is preparing to administer 4,000 units of heparin subcutaneously to a client who has deep-vein thrombosis. Available in heparin 10,000 units/mL. How many mL of heparin should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

A. Bruxism:
Correct Answer: This adverse effect is a priority to report to the provider.
Explanation: Bruxism refers to teeth grinding or clenching, often unconsciously during sleep. It can be a potential side effect of citalopram and other selective serotonin reuptake inhibitors (SSRIs). Bruxism can lead to dental problems, jaw pain, and other discomforts. If this side effect occurs, it should be reported to the provider as it can impact the client's oral health and overall well-being.
B. Confusion:
Incorrect Explanation: While confusion is a concerning adverse effect, it's not typically associated with citalopram use.
Explanation: Confusion is more commonly associated with other medications or medical conditions. If a client experiences confusion, a thorough assessment is warranted, but it may not be directly attributed to citalopram.
C. Weight loss:
Incorrect Explanation: Weight loss can be a side effect of citalopram, but it's not the highest priority in this scenario.
Explanation: Weight loss is a possible side effect of many antidepressants, including citalopram. However, it is generally not as immediately concerning as other adverse effects that can impact a client's health and well-being.
D. Insomnia:
Incorrect Explanation: Insomnia is a common side effect of citalopram and other antidepressants, but it's not the highest priority in this context.
Explanation: Insomnia can be a transient side effect when starting an antidepressant-like citalopram. While it can affect the client's quality of life, it is not as urgent as potential dental issues caused by bruxism.

A. The nurse who identifies the error:
This choice is correct. When a medication error is identified, the nurse who discovers the error is responsible for completing an incident report. Incident reports are a formal way to document any unexpected or adverse events that occur in a healthcare setting, including medication errors. The report helps track incidents, analyze their causes, and implement preventive measures. It's important for the reporting nurse to provide accurate and detailed information about the error.

B. The Quality Improvement Committee:
This choice is incorrect. While the Quality Improvement (QI) Committee plays a role in analyzing trends, identifying areas for improvement, and developing strategies to enhance patient care quality, they are not typically responsible for completing individual incident reports. The responsibility for reporting and documenting a specific incident, such as a medication error, lies with the staff members directly involved.

C. The charge nurse:
This choice is incorrect. The charge nurse is responsible for overseeing the nursing unit's operations, including staffing and patient care coordination. While the charge nurse may be involved in addressing the situation and ensuring appropriate actions are taken following a medication error, they are not necessarily responsible for completing the incident report. The reporting responsibility usually falls on the nurse who identifies the error.

D. The nurse who caused the error:
This choice is incorrect. While it's important for the nurse who caused the error to communicate the error to appropriate parties and participate in any necessary corrective actions, the primary responsibility for completing the incident report usually lies with the nurse who identifies the error. The reporting nurse's perspective is crucial for understanding the context and details of the error.