What is the best course of action if a client taking clomipramine experiences urinary hesitation?

Clomipramine is a tricyclic antidepressant known to potentially cause urinary hesitancy due to its anticholinergic properties, which can result in bladder dysfunction. When a client experiences urinary hesitancy while on clomipramine, it is essential to address the issue promptly, as this side effect can lead to discomfort or further complications.

The most appropriate action is to contact the care provider to recommend a medication change. This is crucial because continuing the medication without any modification could exacerbate the client's symptoms and affect their overall quality of life. It may involve switching to an alternative antidepressant with a more favorable side effect profile or adjusting the dosage.

Monitoring urinary function closely for 48 hours, while useful in some situations, would not be proactive enough in this case since urinary hesitancy could lead to more severe complications if not addressed swiftly. Simply providing the client with increased fluid intake may seem beneficial; however, it can also lead to further urinary retention if the underlying issue is not resolved. Ordering an indwelling urinary catheter would generally be considered a more invasive step and is not typically the first action taken for medication-induced urinary hesitation.

Thus, the best course of action prioritizes the client’s immediate needs and safety