A nurse is caring for a client who has schizophrenia and is taking an antipsychotic medication. Which of the following screening tools should the nurse use to identify tardive dyskinesia?

Restlessness can be a common manifestation of pain. When a client is experiencing unrelieved pain, they may exhibit restlessness, which can include fidgeting, pacing, or frequent position changes in an attempt to find relief. Restlessness may also be accompanied by increased heart rate, elevated blood pressure, and changes in respiratory rate.

Difficulty swallowing (dysphagia) is not a specific indicator of unrelieved pain in a client with a spinal epidural for a herniated disc. Difficulty swallowing can be caused by various factors, including anatomical abnormalities, neurological conditions, or muscle dysfunction.

Constipation is not a specific indicator of unrelieved pain in this scenario. Constipation can be a side effect of certain medications, including opioids that are commonly used to manage pain.

However, it is not an exclusive indicator of unrelieved pain and can be managed through interventions such as adequate hydration, fiber intake, and appropriate bowel regimen.

Urinary retention is not a specific indicator of unrelieved pain in this context. It can be associated with several factors, including the use of certain medications, urinary tract infections, or neurological conditions. Urinary retention may require assessment and management but does not necessarily indicate unrelieved pain.

Incorrect Options

• Osteoporosis: This condition is primarily characterized by bone density loss and an increased risk of fractures. It would not be indicated by bilateral wrist and shoulder stiffness. Instead, osteoporosis symptoms include bone density loss and potentially fractures.
• Hypertension: Hypertension involves consistently high blood pressure. Bilateral wrist and shoulder stiffness are not typical symptoms of hypertension. The primary indicator for hypertension is elevated blood pressure.
• Diabetes Mellitus: This metabolic disorder is characterized by high blood glucose levels. Symptoms related to diabetes include elevated blood glucose levels, not joint stiffness.
• Chronic Obstructive Pulmonary Disease (COPD): COPD is a respiratory condition marked by shortness of breath, chronic cough, and other respiratory symptoms. It would not be indicated by joint stiffness but rather by respiratory difficulties such as shortness of breath.

In contrast, rheumatoid arthritis is an autoimmune disease that primarily affects the joints, leading to symptoms such as bilateral wrist and shoulder stiffness. Therefore, the correct answer is "rheumatoid arthritis" and "bilateral wrist and shoulder stiffness," while the incorrect options provided do not align with the symptoms of rheumatoid arthritis.