A client is receiving tamsulosin, an alpha-adrenergic blocking agent, for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?

Choice A reason:

Insomnia is a known side effect of St. John’s wort. While it can be bothersome, it does not typically require further instruction beyond standard advice on managing insomnia. Patients should be advised to take the medication earlier in the day to minimize sleep disturbances.

Choice B reason:

St. John’s wort can interact with hormonal contraceptives, reducing their effectiveness and increasing the risk of unintended pregnancy. This interaction occurs because St. John’s wort induces the enzymes that metabolize contraceptive hormones, leading to lower levels of these hormones in the body. Therefore, it is crucial to instruct the client to use an additional form of contraception to prevent pregnancy.

Choice C reason:

Sensitivity to the sun, or photosensitivity, is a documented side effect of St. John’s wort. Patients should be advised to use sunscreen and wear protective clothing when exposed to sunlight. While this side effect requires caution, it does not necessitate further instruction beyond these preventive measures.

Choice D reason:

Using hard candy to alleviate dry mouth is a common and effective strategy. St. John’s wort can cause dry mouth, and sucking on sugar-free hard candy can help stimulate saliva production. This advice is appropriate and does not require further instruction.

Calculation Steps

Step 1: Identify the concentration of the medication in the syringe.

The syringe is labeled “Enoxaparin sodium injection, USP 60 mg/0.6 mL.”

Step 2: Calculate the amount of medication per mL.

60 mg ÷ 0.6 mL = 100 mg/mL

Result = 100 mg/mL

Step 3: Determine the prescribed dose.

The prescribed dose is 80 mg.

Step 4: Calculate the volume to administer.

80 mg ÷ 100 mg/mL = 0.8 mL

Result = 0.8 mL

Therefore, the nurse should administer 0.8 mL.