A nurse is caring for a client who has schizophrenia and has been taking a first generation medication for several years. The client is exhibiting jerking movements and twitching of the face and tongue. Which of the following is the client experiencing?

A. Extrapyramidal symptoms. Extrapyramidal symptoms (EPS) include acute dystonia, akathisia, and parkinsonism, which are movement-related side effects caused by dopamine blockade. While EPS can involve muscle rigidity and tremors, tardive dyskinesia specifically refers to chronic, involuntary, repetitive movements such as facial twitching and tongue protrusion. B. Impaired ability to regulate body temperature. Some antipsychotics can interfere with thermoregulation, leading to heat intolerance or hypothermia. However, this is not related to jerking or twitching movements seen in tardive dyskinesia. C. Neuroleptic malignant syndrome. Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to antipsychotics characterized by fever, muscle rigidity, autonomic instability, and altered mental status. Unlike tardive dyskinesia, NMS does not cause chronic, involuntary facial movements but rather widespread muscle stiffness and severe autonomic dysfunction. D. Tardive dyskinesia. Tardive dyskinesia (TD) is a late-onset, irreversible movement disorder caused by long-term use of first-generation antipsychotics. It is characterized by involuntary, repetitive movements, especially in the face, tongue, and extremities (e.g., lip smacking, tongue rolling, grimacing, jerking movements). These symptoms distinguish TD from acute extrapyramidal symptoms.