A nurse is collecting data from a client who is taking enoxaparin. The client reports starting the use of dietary supplements. The nurse should report the use of which of the following supplements to the provider?

A. Probiotics: Probiotics support gut health and do not have significant anticoagulant effects. Their use does not increase bleeding risk or interact directly with enoxaparin, so reporting is not usually necessary. B. Ginkgo biloba: Ginkgo biloba can increase the risk of bleeding by inhibiting platelet aggregation, which may potentiate the anticoagulant effect of enoxaparin. This combination can lead to serious bleeding complications, so the provider should be informed. C. Echinacea: Echinacea primarily supports immune function and does not significantly affect coagulation or interact with enoxaparin. Reporting its use is not critical for anticoagulation safety. D. Flaxseed powder: Flaxseed provides fiber and omega-3 fatty acids but has minimal anticoagulant effect. While it may slightly influence bleeding in large amounts, it is not as concerning as ginkgo and does not typically require immediate provider notification.