A client is seeking treatment for a respiratory infection at a local clinic. During the visit, the client verbalizes concern about the cost of medication and the inability to pay for it. Which of the following responses should the nurse use?

Choice A Reason:

Manual wheelchair is inappropriate. A manual wheelchair requires the use of the client's upper extremities to propel the wheelchair forward by pushing on the wheels. With a spinal cord injury at the fourth cervical level, the client may have limited or no function in their upper extremities, making it difficult to self-propel a manual wheelchair.

Choice B Reason:

Sip-and-puff device is appropriate. A sip-and-puff device allows individuals with limited or no hand function to control a powered wheelchair using their breath. This device enables the client to navigate the wheelchair by inhaling or exhaling into a straw-like device, which activates controls to move the wheelchair forward, backward, and turn.

Choice C Reason:

Drive-adapted wheelchair is inappropriate. A drive-adapted wheelchair is a powered wheelchair that can be modified with adaptive controls to accommodate individuals with limited hand function or mobility. These wheelchairs may include joystick controls, head arrays, chin controls, or other adaptive devices that allow the client to operate the wheelchair independently despite limited hand function.

Choice D Reason:

Ultra-light wheelchairs is inappropriate. Ultra-light wheelchairs are manual wheelchairs that are lightweight and often customized to fit the client's specific needs and preferences. While ultra-light wheelchairs may offer advantages in terms of maneuverability and ease of transportation, they still require sufficient upper extremity function to self-propel the wheelchair.

Choice A Reason:

Memory loss is correct. Memory loss can occur in individuals with PML due to damage to the white matter of the brain caused by the JC virus infection. This damage can affect cognitive function, including memory.

Choice B Reason:

Clumsiness is correct. Clumsiness or lack of coordination is a common neurological symptom of PML. It can result from damage to areas of the brain responsible for motor function and coordination.

Choice C Reason:

Tardive dyskinesia is incorrect. Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements, often involving the face, lips, tongue, and limbs. While tardive dyskinesia can occur as a side effect of certain medications, it is not typically associated with PML.

Choice D Reason:

Seizures is correct. Seizures can occur in individuals with PML due to the involvement of the brain's white matter by the JC virus infection. Seizures may present as sudden, uncontrolled movements, altered consciousness, or other neurological symptoms.

Choice E Reason:

Vision difficulty is correct. Vision difficulties, including blurred vision, visual field deficits, and other visual disturbances, are common manifestations of PML. Damage to the optic nerves or areas of the brain involved in visual processing can result in vision difficulties.