A nurse is caring for a client who is at 26 weeks of gestation. Which of the following statements indicates the client is having difficulty accepting the body image changes associated with pregnancy?

A. Docusate. Docusate is a stool softener that helps prevent constipation, which can be beneficial for clients taking enoxaparin, as straining during bowel movements can increase the risk of bleeding. It does not have anticoagulant properties and does not pose a significant risk of increased bleeding.
B. Cimetidine. Cimetidine, an H2-receptor antagonist used to reduce stomach acid, does not directly increase bleeding risk. However, long-term use can affect liver metabolism and interact with some anticoagulants, but it is not considered unsafe for routine use with enoxaparin.
C. Calcium supplement. Calcium supplements are commonly used for bone health and do not interfere with enoxaparin’s anticoagulant effects. They do not increase bleeding risk and are generally safe for clients taking anticoagulants.
D. Naproxen. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits platelet aggregation and increases the risk of gastrointestinal bleeding. When combined with enoxaparin, which is a low-molecular-weight heparin, the risk of bleeding complications, including gastrointestinal and intracranial hemorrhage, significantly increases. Clients should be advised to use acetaminophen for pain relief instead of NSAIDs while taking enoxaparin.

A. Abnormal Involuntary Movement Scale. The Abnormal Involuntary Movement Scale (AIMS) is a validated tool specifically designed to assess and identify tardive dyskinesia in clients taking antipsychotic medications. The AIMS evaluates the presence, frequency, and severity of involuntary movements, providing a structured approach for monitoring and documenting these symptoms over time.
B. Brief Psychiatric Rating Scale. The Brief Psychiatric Rating Scale (BPRS) is utilized to assess a range of psychiatric symptoms, including depression, anxiety, and psychosis. However, it does not specifically address the assessment of abnormal involuntary movements associated with tardive dyskinesia. Therefore, while it is useful for general psychiatric evaluation, it is not appropriate for identifying tardive dyskinesia.
C. Patient Health Questionnaire-9. The Patient Health Questionnaire-9 (PHQ-9) is a widely used screening tool for assessing the severity of depression. It focuses on mood-related symptoms and does not evaluate movement disorders or side effects of antipsychotic medications. As such, it is not relevant for identifying tardive dyskinesia.
D. Mental Status Examination. The Mental Status Examination (MSE) provides a comprehensive assessment of a client’s cognitive and emotional state, covering areas such as appearance, behavior, thought processes, and mood. While the MSE is valuable for overall psychiatric evaluation, it does not specifically assess for tardive dyskinesia or abnormal involuntary movements, making it unsuitable for this purpose.