After receiving the third dose of a new oral anticoagulant prescription, an older adult client develops bleeding and tender gums and has many new bruises. Which actions should the nurse implement? Select all that apply.

A) Provide a PRN NSAID for gum discomfort: This action is not appropriate because NSAIDs can further increase the risk of bleeding, especially in clients on anticoagulants. Alternative pain management strategies that do not affect coagulation should be considered. B) Obtain a soft bristle toothbrush for the client: This is a recommended action because using a soft bristle toothbrush can help prevent further gum trauma and bleeding. Gentle oral care is important for clients experiencing bleeding gums. C) Complete a medication variance report: This action is not necessary unless there was an error in medication administration. In this case, the symptoms appear to be related to the effects of the anticoagulant rather than a medication error. D) Report findings to the healthcare provider: This is a critical action because the client is experiencing concerning symptoms of bleeding. Prompt communication with the healthcare provider is essential for evaluating the need for intervention, such as adjusting the anticoagulant dosage or providing additional treatments. E) Review most recent coagulation lab values: This action is important to determine the client's current coagulation status and assess the risk of further bleeding. Understanding the lab values will help guide clinical decisions regarding the management of the client's anticoagulation therapy.