A nurse is teaching a client following a cystoscopy about his new prescription for tamsulosin. Which of the following adverse effects should the nurse include in the teaching?

Swelling in the lower extremities suggests fluid overload or inadequate fluid removal during hemodialysis. This indicates that the treatment may not be fully effective in achieving fluid balance, making it a complication rather than a normal post-dialysis finding.

Fatigue is a common and expected symptom after hemodialysis due to fluid and electrolyte shifts, temporary hypotension, and the overall physical stress of the treatment. Clients often report tiredness following sessions, making this a normal symptom.

Improvement in dizziness is consistent with the correction of intradialytic hypotension or fluid imbalances. As the dialysis session progresses and the body stabilizes, clients may feel better, making this a normal recovery symptom rather than a complication.

Difficulty maintaining balance may result from lingering hypotension, electrolyte disturbances, or weakness associated with uremia and dialysis. While mild weakness is expected, balance difficulties can increase fall risk and are best classified as a complication requiring close monitoring.

• Providing antibiotic ointment to the dialysis exit site is a medical order–driven intervention used for infection prevention, not a component of emotional support. While important in care, it does not directly address the psychosocial or supportive needs of the client during dialysis.

• Encouraging questions and discussions about fears allows the nurse to validate the client’s feelings, provide accurate education, and reduce anxiety. Open communication supports coping, enhances trust, and directly fulfills the provider’s order for emotional support and counseling.

• Monitoring for signs of peritonitis is primarily a clinical safety measure rather than emotional support, but it remains an anticipated nursing action during peritoneal dialysis. By ensuring early detection of infection, the nurse indirectly provides reassurance, which helps reduce patient anxiety about complications.

• Restricting fluid intake without considering urinary output is inappropriate because fluid management must be individualized. Overly strict restriction without assessing renal function and residual urine output may worsen the client’s sense of isolation and discomfort.