A home health nurse is assessing a client who has amyotrophic lateral sclerosis (ALS) and has had recent weight loss. Which of the following is the priority admission data for the nurse to obtain?

A) Changes in appetite: While changes in appetite are important to assess, they are not the most immediate concern for a client with ALS who is experiencing weight loss. Appetite changes can contribute to weight loss, but other factors may be more critical.

B) Prescribed medications: Knowing the client’s prescribed medications is essential for overall care, but it is not the priority when addressing recent weight loss in a client with ALS. Medications can affect appetite and weight, but immediate physical concerns should be prioritized.

C) Daily fluid intake: Assessing daily fluid intake is important for hydration status, but it is not the priority in this scenario. Ensuring adequate fluid intake is necessary, but it does not directly address the potential complications related to weight loss in ALS.

D) Swallowing ability: Swallowing ability is the priority admission data to obtain for a client with ALS who has had recent weight loss. ALS can affect the muscles involved in swallowing, leading to dysphagia (difficulty swallowing). This can result in inadequate nutrition and hydration, as well as an increased risk of aspiration. Assessing swallowing ability helps identify the need for interventions such as dietary modifications, swallowing therapy, or alternative feeding methods to ensure the client’s safety and nutritional needs are met.

A) Monitor the client's aPTT levels: While monitoring the activated partial thromboplastin time (aPTT) is important for managing heparin therapy, it is not the immediate priority after a significant medication error. The potential for bleeding due to the overdose is the most critical concern.

B) Check the client for indications of bleeding: This is the first and most crucial action. Assessing the client for signs of bleeding (such as bruising, hematuria, or bleeding gums) is essential to ensure their safety following an overdose of heparin, which can lead to life-threatening complications.

C) Complete an incident report: Documenting the medication error is important for institutional accountability and quality improvement. However, this action should occur after immediate patient safety is addressed.

D) Notify the risk manager: While this is an important step in the reporting process, it should be done after ensuring the client’s safety and taking appropriate actions to address any potential adverse effects of the medication error.