A nurse is caring for a client who received 50,000 units of IV heparin rather than the prescribed 5,000 units. Which of the following actions should the nurse take first?

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.