A client with psychosis who is receiving an antipsychotic medication is continually rubbing the back of the neck. Which nursing intervention is best for the nurse to implement?

Choice A reason: Spinach and other green vegetables are rich in vitamin K, which is essential for blood clotting. However, dabigatran is not affected by vitamin K intake, unlike warfarin, another anticoagulant drug. Therefore, there is no need to eliminate these foods from the diet.

Choice B reason: Dabigatran does not require routine laboratory monitoring of bleeding parameters, such as prothrombin time (PT) or international normalized ratio (INR), unlike warfarin. Therefore, the client does not need to continue obtaining scheduled laboratory bleeding tests.

Choice C reason: Dabigatran is a direct thrombin inhibitor that prevents the formation of fibrin, the main component of blood clots. In case of a major bleeding event, the antidote for dabigatran is idarucizumab, a monoclonal antibody that binds to dabigatran and reverses its effect. However, this antidote is not readily available in most settings and should only be administered by a health care provider. Therefore, the client should not keep an antidote available at home.

Choice D reason: NSAIDs, such as ibuprofen or naproxen, can increase the risk of bleeding by inhibiting platelet aggregation and damaging the gastric mucosa. Therefore, the client should avoid using these drugs while taking dabigatran. The client should consult with the prescriber before taking any other medications, including over-the-counter or herbal products.

Choice A reason: Performing a bladder scan is not the most relevant intervention for monitoring an adverse reaction to tamsulosin. A bladder scan is a non-invasive test that measures the amount of urine in the bladder. It can be used to assess urinary retention, which is a common symptom of benign prostatic hyperplasia. Tamsulosin is a medication that relaxes the smooth muscle of the prostate and bladder neck, which can improve urine flow and reduce urinary retention. However, a bladder scan does not indicate how the medication is affecting the client's blood pressure, which is a more serious concern.

Choice B reason: Assessing urine output is not the most relevant intervention for monitoring an adverse reaction to tamsulosin. Urine output is the amount of urine produced by the kidneys and excreted by the bladder. It can be used to evaluate the client's fluid balance and kidney function. Tamsulosin is a medication that can improve urine flow and reduce urinary retention in clients with benign prostatic hyperplasia. However, urine output does not indicate how the medication is affecting the client's blood pressure, which is a more serious concern.

Choice C reason: Measuring blood pressure is the most relevant intervention for monitoring an adverse reaction to tamsulosin. Blood pressure is the force of blood against the walls of the arteries. It can be affected by various factors, such as heart rate, blood volume, and vascular resistance. Tamsulosin is a medication that belongs to the class of alpha-blockers, which can lower blood pressure by dilating the blood vessels. This can cause side effects such as dizziness, fainting, and orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. The nurse should measure the client's blood pressure regularly and report any abnormal findings to the healthcare provider.

Choice D reason: Monitoring daily weights is not the most relevant intervention for monitoring an adverse reaction to tamsulosin. Daily weights are a measure of the client's body mass, which can reflect changes in fluid status and nutritional intake. Tamsulosin is a medication that can improve urine flow and reduce urinary retention in clients with benign prostatic hyperplasia. However, daily weights do not indicate how the medication is affecting the client's blood pressure, which is a more serious concern.