A nurse is assisting with the admission of a client to the labor and delivery unit.

Exhibits

Which of the following actions should the nurse recommend including in the client's plan of care? For each potential recommendation, click to specify if the recommendation is anticipated or contraindicated for the client. There must be at least 1 selection in every row. There does not need to be a selection in every column.

A. Pivotal Joint (Radius-Ulnar Joint) –A pivot joint allows for rotation around a single axis. The joint between the radius and ulna at the elbow allows the forearm to rotate (pronation/supination). This is not a ball-and-socket joint because it does not allow movement in multiple planes.
B. A ball-and-socket joint allows for the greatest range of motion in multiple directions, including flexion, extension, abduction, adduction, and rotation. Examples are the hip joint (femur-acetabulum) and shoulder joint (humerus-glenoid cavity).
C. A hinge joint allows movement in only one plane (like a door hinge) with flexion and extension. Examples are the knee joint (tibia-femur) and elbow joint (humerus-ulna) function as hinge joints. It is not a ball-and-socket joint because it does not allow rotation or movement in multiple planes.
D. A condyloid (ellipsoidal) joint allows movement in two planes (flexion/extension and abduction/adduction), but no rotation. Examples are the wrist joint (radiocarpal joint) allows side-to-side and up-and-down movements but lacks full rotation.

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.