The nurse is caring for a client who is taking diclofenac, a nonsteroidal anti-inflammatory (NSAID) drug for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client's serum laboratory values is most important for the nurse to review?

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.

Choice A reason: Ginkgo biloba use should be limited and not taken during pregnancy is a true statement, but not the most important information for the nurse to include in the teaching plan. Ginkgo biloba may have adverse effects on the fetus, such as bleeding, seizures, or malformations. However, this information is only relevant if the client is pregnant or planning to become pregnant. The nurse should assess the client's reproductive status and advise her accordingly.

Choice B reason: Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo is the most important information for the nurse to include in the teaching plan. Ginkgo biloba has antiplatelet and anticoagulant properties, which means it can prevent blood clots from forming. However, this also increases the risk of bleeding, especially when combined with other drugs that affect blood clotting, such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDs). The nurse should instruct the client to avoid taking these drugs with ginkgo biloba and inform the healthcare provider of all the medications and supplements she is using.

Choice C reason: Nausea and diarrhea can occur when using this supplement is a possible side effect of ginkgo biloba, but not the most important information for the nurse to include in the teaching plan. Nausea and diarrhea are usually mild and transient, and can be reduced by taking ginkgo biloba with food or water. The nurse should inform the client of this possibility and advise her to report any severe or persistent symptoms to the healthcare provider.

Choice D reason: Anxiety and headaches increase with the use of ginkgo biloba is a false statement, and not the information for the nurse to include in the teaching plan. Ginkgo biloba may actually have beneficial effects on anxiety and headaches, as it can improve blood circulation and oxygen delivery to the brain. The nurse should not discourage the client from using ginkgo biloba for these reasons, unless there is a contraindication or an interaction with other drugs.