A nurse is collecting data from a client who has bipolar disorder. Which of the following findings should the nurse expect?

A. Anorexia: Anorexia, or loss of appetite, is not a typical adverse effect directly associated with heparin use. While it may occur due to general postoperative factors, it is not an urgent or life-threatening reaction that necessitates immediate reporting related to anticoagulant therapy.

B. Epistaxis: Epistaxis, or nosebleed, is a sign of potential bleeding complications, which is a major adverse effect of heparin. Because heparin inhibits clot formation, any evidence of spontaneous bleeding must be reported immediately to the provider to assess for potential heparin-induced bleeding disorders.

C. Weight gain: Weight gain could suggest fluid retention, but it is not a typical adverse effect of heparin. While postoperative clients should be monitored for signs of fluid imbalance, sudden bleeding signs like epistaxis are far more critical to recognize and report when administering anticoagulants.

D. Bradycardia: Bradycardia, or slow heart rate, is not commonly linked to heparin therapy. While abnormal heart rhythms may occur postoperatively for other reasons, they are not typically associated with bleeding risks from heparin and thus do not require urgent reporting specific to heparin use.

A. Use a moisture barrier on the client's skin: Applying a moisture barrier cream helps protect the skin from irritation caused by constant exposure to stool and urine. It creates a protective layer that prevents breakdown, reduces friction, and maintains skin integrity in incontinent clients.

B. Clean the client's skin with soap and hot water: Using soap and hot water can strip the skin of natural oils and cause dryness or irritation, which increases the risk of breakdown. Gentle cleansing with mild soap and lukewarm water is recommended instead to preserve skin health.

C. Massage the area around the client's coccyx: Massaging bony prominences can damage fragile tissue and capillaries in older adults, increasing the risk for pressure injuries rather than preventing them. Light touch is appropriate, but firm massage should be avoided in at-risk areas.

D. Limit the client's fluid intake: Restricting fluids can lead to dehydration, concentrated urine, and an increased risk of urinary tract infections. Adequate hydration is essential to support overall health and skin resilience, even when managing incontinence.