A nurse is teaching a client who has asthma and a prescription for an inhaler. Which of the following instructions should the nurse include?

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) Instruct the client to perform coughing exercises after meals.
Coughing exercises after meals can help clear the airways of mucus, which is beneficial for clients with COPD. Effective airway clearance is crucial to improve breathing and reduce the risk of infections. This intervention can enhance respiratory function and comfort.

B) Limit the client's fluid intake to 1,500 mL/day.
Limiting fluid intake is generally not recommended for clients with COPD unless there is a specific medical reason, such as heart failure. Adequate hydration helps keep mucus thin and easier to expectorate, which is important for respiratory health.

C) Encourage the client to sit in a chair for 1 hr several times per day.
Encouraging the client to sit in a chair helps promote mobility and prevent complications associated with prolonged bed rest. However, while sitting up can improve lung expansion, it is not the most specific or direct intervention to address dyspneic episodes.

D) Initiate oxygen therapy for the client via nasal cannula at 10 L/min.
Administering oxygen at a high flow rate like 10 L/min is not typically appropriate for clients with COPD due to the risk of depressing their respiratory drive. Oxygen therapy should be carefully titrated and monitored based on the client's needs and blood gas levels.