A nurse is caring for a client who has atrial fibrillation and is receiving heparin. Which of the following findings is the nurse’s priority?

Choice A reason: An irregular heart rate without P waves is characteristic of atrial fibrillation, not an acute priority in this context. While it confirms the diagnosis, it is an expected finding and does not indicate an immediate life-threatening complication compared to new neurological symptoms in a client on heparin. Choice B reason: Cloudy, odorous urine suggests a urinary tract infection, which is concerning but not the priority. Infections require treatment, but new neurological symptoms like slurred speech in a client on heparin suggest a possible stroke or bleed, which is more urgent and life-threatening. Choice C reason: Slurred speech in a client on heparin is the priority, as it may indicate a hemorrhagic stroke or transient ischemic attack, both critical complications. Heparin increases bleeding risk, and new neurological symptoms suggest possible intracranial hemorrhage, requiring immediate assessment and intervention to prevent further brain damage. Choice D reason: An aPTT of 80 seconds is within the therapeutic range for heparin (typically 60–80 seconds), indicating effective anticoagulation. While monitoring is necessary, it is not a priority over new neurological symptoms like slurred speech, which could signal a life-threatening complication requiring urgent attention.